The efficiency of preventing hypotension by passive leg raise application in pregnant women scheduled for cesarean section under spinal anesthesia Spinal Anestezi ile Sezaryen Yapilacak Gebelerde Pasif Bacak Kaldirma Uygulamasinin Hipotansiyonu Önlemedeki Etkinliǧi
Anestezi Dergisi, cilt.27, sa.2, ss.36-44, 2019 (Scopus, TRDizin)
- Yayın Türü: Makale / Tam Makale
- Cilt numarası: 27 Sayı: 2
- Basım Tarihi: 2019
- Doi Numarası: 10.5222/jarss.2019.65265
- Dergi Adı: Anestezi Dergisi
- Derginin Tarandığı İndeksler: Scopus, TR DİZİN (ULAKBİM)
- Sayfa Sayıları: ss.36-44
- Anahtar Kelimeler: Anesthesia, Passive leg raising, Post-spinal hypotension, Pregnancy, Spinal
- Sağlık Bilimleri Üniversitesi Adresli: Evet
Özet
Objective: Hypotension which is a complication due to sympathectomy is seen in approximately 60-80% of pregnant women receiving spinal anesthesia which creates appropriate conditions for caesarean section by means of rapid, deep, symmetric sensory and motor block. We aimed to determine the effectiveness of passive leg raising in preventing or reducing the depth of hypotension occured after spinal anesthesia in pregnant women. Method: Forty pregnant women scheduled for cesarean section under spinal anesthesia, between the ages of 18-40 were included in the study.After preoperative administration of antacid prophylaxis and loading doses of 15 ml kg colloid to all patients, highly concentrated 2.2 ml bupivacaine was delivered through L4-5 interspace. After the injection, passive leg raising group were laid in supine position, and operating table was set to predetermined position and legs of the patients were raised to an angle of 30° with their waists. While the control group were left in the supine position. Patients' hemodynamic values were recorded before and 2., 4., 6., 8., 10., 13., 16., 19., 21., 24., 27., 30 minutes after spinal anesthesia. Also the baby's weight, APGAR score and blood gases were measured. Results: Demographic characteristics of the patients were similar and adequate and bilateral block level was achieved in all patients.Systolic arterial pressure were lower at 4. and 6. minutes in the control group and at 16. minutes in the passive leg raising group. The number of patients requiring ephedrine, total amount of ephedrine, and the incidence of hypotension were significantly lower in the passive leg raising group. There was no significant difference between both groups in neonatal evaluation. Considered all patients, as well as intragroup comparisons, there was no difference between the groups with regard to presentation style of pregnant women for cesarean, periods of fasting and weight of infants. Conclusion: Although passive leg raising maneuver after spinal anesthesia did not prevent development of hypotension completely, it was determined that it effectively reduced incidence and severity of hypotension.