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Indian Journal of Anesthesia and Analgesia

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Comparison of Haemodynamic Changes with or without Leg Elevation in Elective LSCS under Spinal Anaesthesia

Bhavini Shah, Associate Professor, Dept. of Anaesthesiology, Dr. D.Y. Patil Medical College, Hospital & Research Centre, Pimpri, Pune, Dr.D.Y. Patil Vidyapeeth, Pune, Maharashtra 411018, India. , Aparna Abhijit Bagle1 , Bhavini Bhushan Shah2 , Shanti Naramaneni3 , Saurabh Kapoor4 , Nayakawadi Sampath Rao5 , Shilpy Jaiswal6

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Indian Journal of Anesthesia and Analgesia 5(6):p 903-907, June 2018. | DOI: http://dx.doi.org/10.21088/ijaa.2349.8471.5618.3

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Abstract

Background: Spinal blockade provides excellent anesthesia for patients undergoing lower segment cesarean section (LSCS). However hypotension after spinal anesthesia is a common adverse effect that is commonly experienced in patients undergoing cesarean section. So our aim is to analyze a simple technique like leg elevation for decreasing the incidence of post spinal hypotension and vasopressor requirement in parturients undergoing cesarean section under spinal anesthesia.

Materials and Methods: Sixty full term patients posted for elective cesarean section belonging to ASAI and II were divided into two groups. Patients preloaded with Ringer lactate at 10 ml/ kg prior to the spinal anesthesia. Spinal anesthesia was given with 0.5% Bupivacaine heavy 2ml. Patients in Group C lower limbs will not be raised and in Group LE will have their legs elevated at 30° with two pillows underneath the calf muscles after spinal anesthesia. The hemodynamic parameters were monitored every 3 minutes until the delivery of the baby and every 5 minutes till the end of surgery. If hypotension occurred, then along with crystalloid loading a bolus dose of inj. Mephentermine 6 mg was given.

Result: Incidence of hypotension in Group C (46.6 %) was significantly more compared to group LE (23.3%). Dose requirement of vasopressor was also significantly less in Group LE.

Conclusion: Legs elevated with two pillows underneath the calf muscles was the simple ,easiest and effective method of controlling post spinal hypotension in caesarean patients and needs to be practiced routinely.

 

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DOI: http://dx.doi.org/10.21088/ijaa.2349.8471.5618.3

Keywords

Postspinal Hypotension; LSCS; Leg Elevation; Vasopressor

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