Wrapping of the lower limbs for prevention of post spinal hypotension during cesarean section under spinal anesthesia

Lee, Jae woo; Kang, Hyoseok; Baek, Seung Kwon; Choi, Juyoun

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Obstetric Anesthesia

Anesthesia and Pain Medicine 2011;6(2):173-177.
Published online April 30, 2011.

Wrapping of the lower limbs for prevention of post spinal hypotension during cesarean section under spinal anesthesia

Jae woo Lee, Hyoseok Kang, Seung Kwon Baek, Juyoun Choi

Department of Anesthesiology and Pain Medicine, Eulji General Hospital, College of Medicine, Eulji University, Seoul, Korea. hskang0108@eulji.ac.kr

Abstract

BACKGROUND
Hypotension is the most frequent complication associated with spinal anesthesia during cesarean section. Prehydration and/or vasopressor therapy is commonly used for prevention of hypotension in cesarean deliveries. Wrapping of the legs is simple to perform before surgery and was reported be effective for the prevention of post spinal hypotension in a few obstetric units. So we investigated whether wrapping of the legs prevents post spinal hypotension during cesarean section.
METHODS
45 patients were randomly allocated to one of 3 groups (15 in each group): prehydration with 10 ml/kg (group I), prehydration with 10 ml/kg and wrapping of the legs (group II), prehydration with 5 ml/kg and wrapping of the legs (group III). Hypotension was defined as a 20% decrease from initial systolic arterial pressure (SAP) or SAP lower than 90 mmHg and was treated with intravenous ephedrine (4 mg, repeated). Blood pressure was recorded before spinal anesthesia and every min for 10 min and then every 2 min for another 10 min after spinal anesthesia.
RESULTS
Group I showed a significant decrease in SAP compared to group II and group III 1 min after spinal anesthesia, but after that, there was no significant difference between the three groups. Group II showed a significant difference in incidence of severe hypotension after spinal anesthesia compared with group I, but there was no difference of the incidence of hypotension between the three groups.
CONCLUSIONS
Wrapping of the legs for prevention of post spinal hypotension during elective cesarean section reduces the severity of hypotension.

Key Words: Cesarean section, Hypotension, Leg wrapping, Spinal anesthesia

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