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

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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.

Perspectives

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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Red Flower Publication Pvt Ltd

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This page is a summary of: Comparison of Haemodynamic Changes with or without Leg Elevation in Elective LSCS under Spinal Anaesthesia, Indian Journal of Anaesthesia and Analgesia, January 2018, Red Flower Publication Private, Ltd.,
DOI: 10.21088/ijaa.2349.8471.5618.3.
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