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Maternal cardiovascular consequences of positioning after spinal anaesthesia for Caesarean section: left 15° table tilt vs. left lateral

✍ Scribed by S. G. O. Rees; J. A. Thurlow; I. C. Gardner; M. J. L. Scrutton; S. M. Kinsella


Publisher
John Wiley and Sons
Year
2002
Tongue
English
Weight
166 KB
Volume
57
Category
Article
ISSN
0003-2409

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✦ Synopsis


Sixty healthy women undergoing elective Caesarean section were randomly allocated to either a measured 15° left table tilt position (n = 31) or full left lateral position (n = 29) for a 15‐min period after spinal blockade. Arm and leg blood pressure, ephedrine requirements, symptoms, fetal heart rate, cord gases and Apgar scores were recorded. Mean ephedrine requirements and incidence of hypotension were similar in the two groups. Arm systolic arterial pressure over time was similar in both groups, but leg systolic arterial pressure over time was significantly lower in the tilt group (p < 0.001); the mean leg systolic arterial pressure was lower for all 15 sequential recordings in the tilt group, reaching statistical significance (p < 0.05) at 4, 5, 6 and 8 min. Differences in maternal nausea, vomiting and bradycardia and fetal outcome were not statistically significant. Following spinal anaesthesia, even a true 15° left table tilt position is associated with aortic compression.


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**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 initia