Comparison of the Hypotension in Lateral Verses Sitting Positions during Induction of Spinal Anaesthesia for Caesarean Section

Abstract

Objective: To compare the hypotension in lateral verses sitting positions during induction of spinal anaesthesia for caesarean section. Study Design: This is a Randomized control trial (RCT) study. Setting: Study carried out at Department of Anaesthesiology, Surgical Intensive Care Unit and Pain Management, Civil Hospital, Dow University of health sciences Karachi, from December 2018 to June 2019. Materials and Methods:  All women age 18 to 45 underwent elective caesarian section having ASA I and II, singleton pregnancy on ultrasound with parity ≤3 were enrolled. Patients were randomized to receive spinal anaesthesia in the lateral position (Group L) or the sitting position (Group S) through lottery methods. Using the L3-4 interspace, patients received intrathecal plain bupivacaine, 10mg or 12 mg according to their height, after which they was placed immediately in the supine position with left uterine displacement. Maternal blood pressure was measured with the help of Non-invasive BP apparatus. BP was recorded at baseline then every 5 min till 30 minutes by anesthetist who was unaware of parturient group. Any single or more reading of SBP of <90 mmHg was considered as Hypotension. Results: Mean age of the patients in lateral group was 31.49 ±10.87 years and mean age of the patients in sitting group was 31.80 ±10.77 years (p-value 0.869). Majority of the patients 35 (62.5%) with hypotension were presented with sitting position. Chi square test was applied and statistically significant difference was observed between groups (p-value 0.012).  Conclusion: We concluded that less frequency of hypotension was observed when spinal anaesthesia for caesarean section using plain bupivacaine in the lateral position.