Abstract PR200

Abstract

Background & Objectives: Patient position after spinal anesthesia had variable effects on hemodynamic stability, sensory and motor blocks level. The aim of this study was to determine the effects that sitting the patient up for three minutes or one minute after spinal anesthesia would have on perioperative hemodynamic measurament, ephedrine, requirement, sensorial and motor blocks levels and postoperative recovery. Materials & Methods: Ninety parturients undergoing elective cesarean delivery under spinal anesthesia were enrolled in this prospective randomized controlled trial. After the spinal injection, the women were randomized either to sit up for three minutes (Group 3) or one minute (Group 1) then lie down or to lie down immediately (Group 0) to a tilted supine position. Hemodynamics, including the incidence of hypotension, ephedrine dose required, and characteristics of the sensory and motor blocks were analyzed. Results: Parturients characteristics were similar in all groups. The incidence of hypotension and the required dose of ephedrine were lower in Group 3 compared to Group 1 and Group 0 (p<0.01 and p< 0.001). Group 3 had a lower intraoperative sensory block height than Group 1 and Group 0 (T4 [T2-6] vs T2 [T1-T6] and T2 [C7-T6], respectively; p< 0.001). In Group 0, the time to achieve maximal sensory block level was shorter than in Group 3 and Group 1 (7.8±4 min vs 11±3 min and 13±6 min, respectively, p< 0.05). Time to a Bromage score of 2 was longer in Group 3 than in other groups. There were no differences in Apgar scores between groups (p = 0.121). Conclusion: We demonstrated that when parturients undergoing cesarean delivery were maintained in the sitting position for three minutes after spinal injection of the local anesthetic resulted in sensory block levels, incidence of hypotension and ephedrine requirements that were lower compared with other groups.