Title: To Study the Hemodynamic Changes after Leg Wrapping In Elective Cesarean Section under Spinal Anesthesia
Authors: Dr Amit Pradhan, Dr Tarangini Das, Dr Sidharth Sraban Routray, Dr Kamalakanta Pradhan, Dr Khageswar Raut
DOI: https://dx.doi.org/10.18535/jmscr/v4i11.66
Abstract
Background & Aim: Spinal anesthesia is commonly used for cesarean section, but it is usually associated with side effects like hypotension, which may be detrimental to mother and baby. Over past few years, many pharmacological interventions have been tried to prevent hypotension, but no single technique has proven to be ideal. This study was carried out with the aim to find whether wrapping the legs with elastic crepe bandage in addition to conventional approach was effective in preventing hypotension due to spinal anesthesia.
Method: A total of 60 full-term patients with an uncomplicated pregnancy belonging to American Society of Anesthesiologists I or II were allocated randomly (30 in each group) to have their legs wrapped with elastic crepe bandage (Group A) or no wrapping(Group B). All patients were administered intravenous (IV) crystalloid (20 ml/kg) 15-20 min prior to spinal anesthesia. Electrocardiography and oxygen saturation was monitored continuously and heart rate, blood pressure was measured every 2 min until delivery of baby and every 5 min thereafter until end of surgery. Hypotension was treated with IV phenylephrine 50 µg.
Results: The incidence of hypotension was significantly less (P = 0.002) in Group A (legs wrapped group) when compared with Group B (non leg wrapped). In Group A 3 (10%) patients and in Group B 15(50%) patients required rescue dose with phenylephrine which was statistically significant (P = 0.004). Difference in the systolic, diastolic and mean arterial pressure between Group A and B was recorded and found significant between 4 to 15 min after spinal anesthesia.
Conclusion: There was less incidence of hypotension due to wrapping of legs with elastic crepe bandage with a subsequent reduction in the requirement of of phenylephrine. Leg wrapping with crepe bandage is cheap, easy, readily available, noninvasive, and non pharmacological and most important it had least effect on baby. So leg wrapping can be recommended for preventing hypotension in spinal anesthesia.
Key words-Leg wrapping, hypotenson,spinal anaesthesia.
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