IMR Press / CEOG / Volume 44 / Issue 1 / DOI: 10.12891/ceog3212.2017

Clinical and Experimental Obstetrics & Gynecology (CEOG) is published by IMR Press from Volume 46 Issue 1 (2019). Previous articles were published by another publisher on a subscription basis, and they are hosted by IMR Press on imrpress.com as a courtesy and upon agreement with S.O.G.

Open Access Original Research
Maintenance of the parturient in the left lateral position after spinal anesthesia with plain levobupivacaine for cesarean section reduces hypotension: a randomized study
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1 Gaziantep University, Department of Anesthesiology and Reanimation, Gaziantep, Turkey
2 Obstetric and Gynecology Government Hospital, Gaziantep, Department of Anesthesiology and Reanimation, Gaziantep, Turkey
3 Sehitkamil Government Hospital, Gaziantep, Department of Anesthesiology and Reanimation, Gaziantep, Turkey
Clin. Exp. Obstet. Gynecol. 2017, 44(1), 77–80; https://doi.org/10.12891/ceog3212.2017
Published: 10 February 2017
Abstract

Purpose of Investigation: Hypotension during spinal anesthesia is a main concern in cesarean delivery. The authors hypothesized that keeping parturients in a prolonged left lateral position before turning them to a supine position with left lateral tilt would reduce the incidence of hypotension without jeopardizing the quality of anesthesia. Materials and Methods: Randomized comparative unblinded prospective study. This randomized comparative prospective study was conducted at Gaziantep University Hospital between June and December 2011. Sixty parturients undergoing cesarean section were included. Patients were randomized to two groups: turning to the supine position with left lateral tilt immediately or 15 minutes after subarachnoid injection of 2.5 ml 0.5% plain levobupivacaine in the left lateral position. Loss of pinprick sensation to T6 was accepted as adequate for cesarean section, and surgery proceeded. Characteristics of anesthesia; incidences of hypotension, bradycardia, and other adverse events, and ephedrine use were assessed. Results: Compared with the supine group, parturients kept in a lateral position for 15 minutes showed marked reductions in the incidence of hypotension (33.3% vs. 83.3%, p < 0.001) and adverse events related to hypotension, such as nausea and vomiting (16.7% vs. 57.3%, p < 0.001). In addition, ephedrine consumption per hypotension case was significantly reduced in the lateral group (5.4 ± 4.7 vs. 8.9 ± 5.8 mg; p < 0.001). Conclusions: Keeping parturients in the lateral position for 15 minutes before turning them to the supine position for cesarean section can provide reliable spinal anesthesia with a lower incidence and severity of hypotension and nausea/vomiting.
Keywords
Cesarean section
Position
plain levobupivacaine
Spinal anesthesia
Pain
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