Use of sequential compression device for prevention of hypotension associated with spinal anesthesia in elective caesarean section

Abstract

A very high incidence of hypotension associated with spinal anesthesia (SA) is a matter of concern in obstetric anesthesia and a stable hemodynamic status is required to reduce morbidity furthermore to improve maternal safety. In this study we aim to evaluate the efficacy of sequential compression device for prevention of spinal anesthesia induced hypotension as compared to the standard crystalloid preloading.In this prospective randomized study, total 80 patients with ASA grade I/II divided were enrolled after ethical approval. The patients were randomly allocated into two groups (40 patients in each group) using the computer generated random table. Mechanical Pump (Group M): Sequential compression device was applied and discontinuous compression was started at 60 mmHg and Crystalloid group (Group C) - Patients were preloaded with Ringer’s lactate (RL) at dose of 10 ml/kg for not more than 10 minutes. Spinal block was given and RL was started at rate of 10-15 drops/min to keep venous line patent. The Chi Square test and Unpaired Student’s‘t’ tests were used. Statistically significant differences were observed in heart rate, systolic BP, diastolic BP, mean arterial pressure. The percentage drop in systolic BP from baseline was significantly more in crystalloid group (p=0.043). The sequential compression device is useful for prevention of hypotension in pregnant females undergoing elective caesarean section under spinal anesthesia.