Passive Leg Elevation to Prevent Newborn Low APGAR and Hypotension of Mothers Undergoing a Spinal Anesthesia for Elective Caesarean Section

Document Type : Original Article (s)

Authors

1 Associate Professor, Department of Anesthesiology and Critical Care, School of Medicine AND Anesthesiology and Critical Care Research Center, Isfahan University of Medical Sciences, Isfahan, Iran

2 Associate Professor, Department of Gynecology and Obstetrics, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran

3 Student of Medicine, School of Medicine AND Student Research Committee, Isfahan University of Medical Sciences, Isfahan, Iran

Abstract

Background: Hypotension occurs significantly during cesarean operation with spinal anesthesia. This side-effect can be harmful to the mother and the fetus. In this study, impact of passive leg elevation maneuver on prevention of mother hypotension and newborn APGAR index was examined.Methods: Totally, 105 mothers, in three groups of 35, were examined with different leg angles after spinal anesthesia and the impact of these maneuvers on pulse rate, mother blood pressure and APGAR index was checked.Findings: The relative rates of mother hypotension, relative rates of nausea and vomiting during and after working, mean of need to ephedrine between the 3 groups, and newborn APGAR indexes in the first and fifth minutes in each group were significantly different. Mean maximum and minimum mother pulse rate, the mean interval time between applying spinal anesthesia and the occurrence of the mother hypotension, and newborn APGAR indexes were not significantly different between the 3 groups.Conclusion: This study shows that increasing the angle of leg after spinal anesthesia has impact on consequences of hypotension. 

Keywords

References

  1. Mercier FJ, Bonnet MP, De la Dorie A, Moufouki M, Banu F, Hanaf A, et al. Spinal anaesthesia for caesarean section: fluid loading, vasopressors and hypotension. Ann Fr Anesth Reanim 2007; 26(7-8): 688-93. [In French].
  2. Bjornestad E, Rosseland LA. Anaesthesia for Caesarean section. Tidsskr Nor Laegeforen 2010; 130(7): 748-51. [In Norwegian].
  3. Bertolissi M, Da BU, Soldano F, Bassi F. Influence of passive leg elevation on the right ventricular function in anaesthetized coronary patients. Crit Care 2003; 7(2): 164-70.
  4. Ngan Kee WD. Prevention of maternal hypotension after regional anaesthesia for caesarean section. Curr Opin Anaesthesiol 2010; 23(3): 304-9.
  5. Ngan Kee WD, Khaw KS, Ng FF. Prevention of hypotension during spinal anesthesia for cesarean delivery: an effective technique using combination phenylephrine infusion and crystalloid cohydration. Anesthesiology 2005; 103(4): 744-50.
  6. Sood J. Prevention of hypotension after SAB in caesarean delivery. New Delhi, India: Department of Anaesthesiology, Pain and Perioperative Medicine, Sir Ganga Ram Hospital; 2011.
  7. Lee SC, Hong MG, Lee KW. The effect of lower extemities elevation on anesthetic level and vital signs during spinal anesthesia. Korean J Anesthesiol 1995; 28(3): 440-6.
  8. Cyna AM, Andrew M, Emmett RS, Middleton P, Simmons SW. Techniques for preventing hypotension during spinal anaesthesia for caesarean section. Cochrane Database Syst Rev 2006; (4): CD002251.
  9. Ng K, Parsons J, Cyna AM, Middleton P. Spinal versus epidural anaesthesia for caesarean section. Cochrane Database Syst Rev 2004; (2): CD003765
  10. van Bogaert LJ. Prevention of post-spinal hypotension at elective cesarean section by wrapping of the lower limbs. Int J Gynaecol Obstet 1998; 61(3): 233-8.
  11. Wong DH, Tremper KK, Zaccari J, Hajduczek J, Konchigeri HN, Hufstedler SM. Acute cardiovascular response to passive leg raising. Crit Care Med 1988; 16(2): 123-5.
  12. Rutlen DL, Wackers FJ, Zaret BL. Radionuclide assessment of peripheral intravascular capacity: a technique to measure intravascular volume changes in the capacitance circulation in man. Circulation 1981; 64(1): 146-52.
  13. 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.
  14. Miyabe M, Sato S. The effect of head-down tilt position on arterial blood pressure after spinal anesthesia for cesarean delivery. Reg Anesth 1997; 22(3): 239-42.
Journal of Isfahan Medical School
Volume 32, Issue 299 - Serial Number 299
July and August 2014
Pages 1363-1370

Files

History

  • Receive Date: 30 April 2013
  • Revise Date: 26 May 2024
  • Accept Date: 06 April 2022

Share

How to cite

Statistics