Elektif Sezaryenlerde Bacak Kaldırma Spinal Kaynaklı Hipotansiyonu Önler mi? Randomize Kontrollü Bir Çalışma

Amaç: Elektif sezaryen (C/S) ameliyatlarında spinal anesteziye bağlı hipotansiyonu önlemede bacak kaldırma (LR) yönteminin etkinliğini araştırmayı amaçladık. Yöntem: Çalışmaya 140 term gebe dahil edildi. Hastalar bacak kaldırma grubu (Grup L, n=70) ve kontrol grubu (Grup C, n=70) olarak iki gruba ayrıldı. Spinal anestezi sonrası Grup L’deki hastaların topuklarının altına yatay düzlemle 30 derecelik açı yapacak şekilde yükseklik yerleştirildi. Grup C’de herhangi bir müdahale yapılmadı. Belirlenen aralıklarla hastaların hemodinamik ve operasyon verileri kaydedildi. Bulgular: Grup L’de 29 (%41,4) hastada hipotansiyon görülür iken, Grup C’de 54 (%77,1) hastada hipotansiyon gelişti (p

Does Leg Raising Prevent Spinal-Induced Hypotension in Elective Cesarean Sections? A Randomized Controlled Study

Objective: We aimed to investigate the effectiveness of the leg raising (LR) method in preventing spinal anesthesia-induced hypotension in elective cesarean section (C/S) operations. Methods: One hundred and forty term pregnant women were included in the study. The patients were divided into two groups as leg raising group (Group L, n=70) and the control group (Group C, n=70). After spinal anesthesia, a cushion was placed under the heels of the patients in Group L at an angle of 30 degrees with the horizontal plane. No intervention was made in Group C. The patients’ hemodynamic and operation data were recorded at determined intervals. Results: In Group L, hypotension was observed in 29 (41.4%) patients while 54 (77.1%) patients developed hypotension in Group C (p

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  • 1. Betrán AP, Merialdi M, Lauer JA, et al. Rates of caesarean section: analysis of global, regional and national estimates. Paediatr Perinat Epidemiol 2007;21(2):98-113.
  • 2. D’Angelo R, Smiley RM, Riley ET, Segal S. Serious complications related to obstetric anesthesia: The serious complication repository project of the Society for Obstetric Anesthesia and Perinatology. Anesthesiology 2014;120(6):1505-12.
  • 3. Boutonnet M, Faitot V, Keita H. Airway management in obstetrics. Ann Fr Anesth Reanim 2011;30(9):651-64.
  • 4. Campbell JP, Stocks GM. Management of hypotension with vasopressors at caesarean section under spinal anaesthesia - have we found the Holy Grail of obstetric anaesthesia? Anaesthesia 2018;73(1):3-6.
  • 5. Chooi C, Cox JJ, Lumb RS, et al. Techniques for preventing hypotension during spinal anaesthesia for caesarean section. Cochrane Database Syst Rev 2017;8(8):CD002251.
  • 6. Klöhr S, Roth R, Hofmann T, Rossaint R, Heesen M. Definitions of hypotension after spinal anaesthesia for caesarean section: Literature search and application to parturients. Acta Anaesthesiol Scand 2010;54(8):909-21.
  • 7. Hasanin A, Aiyad A, Elsakka A, et al. Leg elevation decreases the incidence of post-spinal hypotension in cesarean section: A randomized controlled trial. BMC Anesthesiol 2017;17(1):60.
  • 8. Van de Velde M. Low-dose spinal anesthesia for cesarean section to prevent spinal-induced hypotension. Curr Opin Anaesthesiol 2019;32(3):268-70.
  • 9. Assen S, Jemal B, Tesfaye A. Effectiveness of leg elevation to prevent spinal anesthesia-induced hypotension during cesarean delivery in the resource-limited area: Open randomized controlled trial. Anesthesiol Res Pract 2020;8:e5014916.
  • 10. Hanss R, Bein B, Ledowski T, et al. Heart rate variability predicts severe hypotension after spinal anesthesia for elective cesarean delivery. Anesthesiology 2005;102(6):1086- 93.
  • 11. Adsumelli RSN, Steinberg ES, Schabel JE, Saunders TA, Poppers PJ. Sequential compression device with thigh-high sleeves supports mean arterial pressure during Caesarean section under spinal anaesthesia. Br J Anaesth 2003;91(5):695-8.
  • 12. Rout CC, Rocke DA, Gouws E. Leg elevation and wrapping in the prevention of hypotension following spinal anaesthesia for elective caesarean section. Anaesthesia 1993;48(4):304- 8.
Anestezi Dergisi-Cover
  • ISSN: 1300-0578
  • Yayın Aralığı: Yılda 4 Sayı
  • Başlangıç: 1993
  • Yayıncı: Betül Kartal