Does the maternal position at the time of administration of subarachnoid block with plain Ropivacaine affect the hemodynamics? A comparative evaluation of the sitting versus lateral position
Journal Title: International Journal of Medical and Health Sciences - Year 2017, Vol 6, Issue 4
Abstract
Background: Subarachnoid block is the preferred anesthesia in the parturient undergoing elective caesarean section. The ideal position for the induction of subarachnoid block in a parturient is not standardized and its effect on the hemodynamics is conflicting. Methods: A prospective randomized single blinded study was carried out on 40 parturients. The parturient were allocated to two groups of 20 each, who received 12 mg of 0.75% plain Ropivacaine intrathecally in either the modified sitting or the lateral position. The intra-operative hemodynamic parameters, characteristics of block, amount of Ephedrine used, neonatal condition (Apgar score), nausea, vomiting and parturient comfort were evaluated. Results: As compared to the lateral group, a greater fall in mean arterial pressure (P=0.001) and systolic blood pressure (P=0.002) was observed in the sitting group. The mean amount of Ephedrine used was also greater in the sitting group (P=0.011).The time to achieve a sensory level of T6 was earlier (P value<0.001) and the highest sensory level achieved was greater in the sitting group (P value=0.002). The incidence of nausea (P=0.002) and vomiting (P=0.008) was more in the sitting group. However, the parturient were more comfortable receiving the block in sitting position (P value<0.001) and the overall neonatal outcome was good in both the groups. Conclusions: We conclude that even though the sitting position was comfortable while administering a subarachnoid block, maintaining the lateral position at the time of subarachnoid administration provided significantly greater hemodynamic stability.
Authors and Affiliations
Himanshu Sikri, Bharti Taneja, Kirti Nath Saxena
Keywords
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