Comparing Effect of Lateral Versus Sitting Position on Hemodynamics and on set of Sensory Block During Induction Time of Spinal Anesthesia in Patients Undergoing Elective Cesarean Section, at Ghandi Memorial Hospital Addis Ababa; Ethiopia: A Prospective Cohort Study,2022/2023
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Date
2023-06-19
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Addis Ababa University
Abstract
Spinal anesthesia is the preferred anesthetic technique for cesarean sections. It can be given in a lateral or sitting position. But maternal positioning affects hemodynamics and the spread of local anesthetic drugs that also affect the onset of sensory block. Post-spinal hypotension is the major problem that occurs after spinal anesthesia. It is defined as a decrease in systolic blood pressure greater than 20% of the baseline measurement. Even though precautionary measures have been taken to alleviate post-spinal hypotension, it still occurs at a rate of 30–90% after spinal anesthesia, and it needs research to indicate at what position it will be pronounced.
Objective: The main objective of this study was to compare the effect of sitting versus lateral position on hemodynamics and the onset of sensory block during the induction time of spinal anesthesia in patients undergoing cesarean section at Gandhi Memorial Hospital in Addis Ababa, Ethiopia, from December 30, 2022, to April 30, 2023.
Methods: A prospective cohort study was applied to 170 parturients who had undergone elective cesarean delivery under spinal anesthesia. Data was analyzed using SPSS version 27, after checking the normality of the data distribution. An independent t-test was used to analyze parametric data, and a Mann-Whitney u-test was used for the analysis of non-parametric data. A chi-square test was employed to compare categorical variables. A statistical significance is determined when P <0.05.
Result: There was no statistically significant difference between the two groups in terms of socio-demographic data (P > 0.05). The incidence of hypotension in the lateral and sitting groups was 25% and 75%, respectively (P = 0.036). The lowest recorded median systolic blood pressure was 95 mm Hg in the lateral group and 87 mm Hg in the sitting group. The onset of sensory block was also faster in the lateral position than the sitting position (P <0.05).
Conclusion and Recommendation: The changes in maternal hemodynamics were better maintained in lateral position than sitting position, and adequate sensory level for cesarean section is attained quicker in lateral position as compared to sitting position in patients undergoing spinal anesthesia for cesarean section. We recommend using the lateral position as
the sole induction position during spinal anesthesia.
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maternal hemodynamics and onset of sensory block during induction time of spinal anesthesia