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Table Tilt Versus Pelvic Tilt Position for Preventing Hemodynamic Changes During Spinal Anaesthesia for Caesarean Section

Balasubramanian S. , Badrinath1 , Balasubramanian2 , Suresh Kumar3 , Suneeth P. Lazarus4 , Rajprasath5

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Indian Journal of Anesthesia and Analgesia 6(2):p 399-406, MARCH-APRIL 2019. | DOI: http://dx.doi.org/10.21088/ijaa.2349.8471.6219.5

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Puligoru Badrinath, Shanmugam Balasubramanian, Kuppusamy Suresh Kumar et al. Table Tilt Versus Pelvic Tilt Position for Preventing Hemodynamic Changes During Spinal Anaesthesia for Caesarean Section. Indian J Anesth Analg. 2019;6(2):399-406.

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Abstract

Background: Hypotension is one of the most common complications associated with regional anaesthetic technique for CS. Several studies have been done for methods to prevent hypotension, which have been widely discussed in past decades, without definite conclusions. Hence we designed a study as such to compare the effect of placing a Crawford wedge or giving a table tilt (left) after spinal anesthesia for caesarean section, by observing the hemodynamic changes as suggested by previous study, to determine which would be best suit for cesarean section parturients in preventing supine hypotension syndrome. Materials and Methods: A total of 120 parturients who met the inclusion criteria were enrolled into the study and were randomly allocated into either the wedge group or the table tilt group. After placing the wedge or table tilt, patient hemodynamic parameters such as Heart rate, Blood pressure, Oxygen saturation were recorded between the groups. Results: In Tilt group 50% were Primigravida and 50% were Multigravida respectively, in wedge group 45% were Primigravida and 55% were Multigravida. Mean Hear rate increased to 90.2 ± 8.7 bpm at 10 min in Tilt group and to 90.6 ± 9.1 bpm at 20 min in Wedge group. Mean SBP was higher in Wedge group after 5 min of positioning than in tilt group. Mean DBP was higher in Wedge group after 5 min of positioning than in tilt group. Mean MAP was higher in Wedge group after 5 min of positioning than in tilt group. The results show that there is no significant differences regarding Heart rate, systolic blood pressure, diastolic blood pressure, mean arterial blood pressure, saturation between wedge group and table tilt group. Conclusion: We observed that there was incidence of hypotension in both the groups but the placement of Crawford wedge and execution of table tilt were equally efficient in preventing supine hypotension syndrome for patient undergoing cesarean section.

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Puligoru Badrinath, Shanmugam Balasubramanian, Kuppusamy Suresh Kumar et al. Table Tilt Versus Pelvic Tilt Position for Preventing Hemodynamic Changes During Spinal Anaesthesia for Caesarean Section. Indian J Anesth Analg. 2019;6(2):399-406.

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DOI: http://dx.doi.org/10.21088/ijaa.2349.8471.6219.5

Keywords

Caeserean section; Spinal Anaesthesia; Wedge; Table tilt; Supine Hypotension.

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