English

Abstract

BACKGROUND: Hemodynamic disturbance and uteroplacental hypoperfusion can occur due to Aortocaval Compression (ACC) in parturient which are further aggravated by SAB. Incidence of maternal hypotension due to cephalad spread of local anesthetic (LA) in subarachnoid space and ACC by gravid uterus; both these factors influenced by parturient's posture during and immediately after SAB, we tested the hypothesis that keeping parturient in sitting position for five minutes after SAB, likely limit the spread of LA, thus reduce the incidence of hypotension and Intraoperative ephedrine requirements. AIMS AND OBJECTIVES: to determine the effects of making parturient sit up for five minutes after SAB, that would have on sensory block height, incidence of hypotension and ephedrine requirements. Secondarily, to study duration of postoperative analgesia. MATERIALS AND METHODS; Single blinded randomized comparative study having 30 parturients in each group CS and CL were allocated to receive 2ml of hyperbaric bupivacaine with 0.4ml NS, Or 20 µgm fentanyl added to 2 ml hyperbaric bupivacaine group FS or FL, either in sitting group (made to sit for 5 min. post SAB before supine) or in lying group, made supine immediately. The maximum level of sensory blockade achieved and monitoring of heart rate, noninvasive blood pressure, respiratory rate and oxygen saturation were done every 2 min for first 10 min then at 15 min interval for remainder of operation. Postoperatively, onset of pain was noted. STATISTICAL ANALYSIS: By using descriptive and inferential statistics using unpaired t-test, chi Square test, and Mann-Whitney U test. The Software used was SPSS 17.0 version and Graph Pad Prism 5.0. Analyzed data was expressed as mean ± SD for continuous variables and number (%) for categorical variables. P value < 0.05 was considered statistically significant RESULTS: Sitting Groups had lower sensory block height than lying Groups; also required less ephedrine. Duration of postoperative analgesia was prolonged in both the fentanyl Groups. CONCLUSION: prolonged sitting position after spinal anesthesia not only limit the spread of LA, producing lower sensory block height but also reduces the incidence of