Hypotension following combined spinal-epidural anaesthesia for Caesarean section : Left lateral position vs. tilted supine position

✍ Scribed by C. Mendonca; J. Griffiths; B. Ateleanu; R. E. Collis

• Publisher: John Wiley and Sons
• Year: 2003
• Tongue: English
• Weight: 79 KB
• Volume: 58
• Category: Article
• ISSN: 0003-2409
• DOI: 10.1046/j.1365-2044.2003.03090.x

✦ Synopsis

Summary Eighty‐seven pregnant mothers undergoing elective Caesarean section were randomly allocated either to the full left lateral position (n = 45) or to the supine position with 12° left lateral tilt (n = 42) after a combined spinal–epidural (CSE) in the sitting position and an initial 2 min in the full right lateral position. Fewer mothers were hypotensive while in the study position [29 (64%) in lateral group vs. 38 (90%) in the tilted supine group; p = 0.03]. Mothers in the lateral group tended to become hypotensive after turning them back to the tilted supine position immediately before surgery; hence the number of mothers who were hypotensive from the insertion of the CSE until delivery were similar [36 (80%) vs. 38 (90%)]. Mothers in the lateral group needed a lower dose of ephedrine to treat their hypotension while in their study position {median (interquartile range [range]) 6 (0–12 [0–36]) mg vs. 12 (6–18 [0–36]) mg, respectively; p = 0.04} but ephedrine requirements were similar overall {12 (6–12 [0–36]) mg vs. 12 (6–18 [0–36]) mg}, respectively. The full left lateral position reduces the incidence of early hypotension compared with the tilted supine position with tilt, and makes it easier to treat.