Comparison of the effect of induction position in spinal anaesthesia on sensory block in pregnant women undergoing elective lower segment caesarean section with hyperbaric bupivacaine

Abstract

Aims and Objective: The aim of the study was to compare the characteristics of sensory blockade, intraoperative hemodynamic changes and the need for vasopressors when spinal anaesthesia was induced in the left lateral decubitus position and sitting position in Elective Lower Segment Caesarean Section cases in hospital setting. Methods: 64 parturient of ASA I /II at full term gestation and presenting for Elective Lower Segment Caesarean Section surgery were enrolled and allocated to either of two groups, Group 1:(( Parturient in sitting position during induction of spinal anaesthesia (n=32)) and Group 2(: Parturient in left lateral decubitus position during induction of spinal anaesthesia (n=32)) using computer generated random numbers in this prospective randomised double blind study.2ml of 0.5% hyperbaric bupivacaine was injected into intrathecal space while the patients were in sitting or left lateral decubitus position at L3-L4 level. Sensory block characteristics and hemodynamic parameters were recorded and analysed. Result: Demographic profile were comparable in both groups. No statistical significant differences were observed between the two study groups in sensory block characteristics and haemodynamic parameters during entire observation period during induction of spinal anaesthesia. Conclusion: The study concludes that spinal anaesthesia with 2mL of 0.5% hyperbaric bupivacaine in both sitting position and left lateral decubitus position provides effective anaesthesia for Lower Segment Caesarean Section ensuring good hemodynamic stability and comparable sensory block characteristics. Introduction The delivery of a baby to a conscious and pain free mother is one of the most exciting and rewarding moments in medicine. 1 Quality and choice in anaesthesia for caesarean section have significantly improved over the last two decades. This change in practice may have been responsible for the fall in anaesthetic deaths in pregnant women that had occurred over the same period. 2 In the recent decades there has been a worldwide shift in obstetric anaesthesia practice in favour of regional anaesthesia. 3,4 Regional anaesthesia is more preferred because of less risk of gastric aspiration, failed intubation and depressant effects of anaesthetics drugs on foetus. 5 The boom in www.jmscr.igmpublication.org Index Copernicus Value: 79.54 ISSN (e)-2347-176x ISSN (p) 2455-0450 DOI: https://dx.doi.org/10.18535/jmscr/v7i6.160