Volume 03 Issue 06-2023
65
International Journal of Medical Sciences And Clinical Research
(ISSN
–
2771-2265)
VOLUME
03
ISSUE
06
P
AGES
:
65-69
SJIF
I
MPACT
FACTOR
(2021:
5.
694
)
(2022:
5.
893
)
(2023:
6.
184
)
OCLC
–
1121105677
Publisher:
Oscar Publishing Services
Servi
ABSTRACT
This comparative study aims to evaluate the hemodynamic effects of the lateral and sitting positions during the
induction of spinal anesthesia for lower segment caesarean section (LSCS). The study examines changes in blood
pressure, heart rate, and oxygen saturation levels in pregnant women undergoing LSCS under spinal anesthesia in
either the lateral or sitting position. A total of [number] pregnant women are included in the study, with half of them
randomly assigned to the lateral position group and the other half to the sitting position group. Hemodynamic
parameters are monitored at baseline, during the induction of spinal anesthesia, and at regular intervals throughout
the surgery. The findings of this study provide valuable insights into the optimal positioning for spinal anesthesia
induction during LSCS, helping to ensure the safety and stability of maternal hemodynamics during the procedure.
KEYWORDS
Hemodynamics, lateral position, sitting position, spinal anesthesia, lower segment caesarean section (LSCS), blood
pressure, heart rate, oxygen saturation, pregnant women, comparative study.
INTRODUCTION
Research Article
HEMODYNAMIC EFFECTS OF LATERAL AND SITTING POSITIONS IN
SPINAL ANESTHESIA INDUCTION FOR LOWER SEGMENT CAESAREAN
SECTION: A COMPARATIVE STUDY
Submission Date:
June 11, 2023,
Accepted Date:
June 16, 2023,
Published Date:
June 21, 2023
Crossref doi:
https://doi.org/10.37547/ijmscr/Volume03Issue06-13
Dr Neha Vakamudi
Assistant Professor, Department of Anesthesia, S.P. Medical College and Pbm Hospital, Bikaner, India
Journal
Website:
https://theusajournals.
com/index.php/ijmscr
Copyright:
Original
content from this work
may be used under the
terms of the creative
commons
attributes
4.0 licence.
Volume 03 Issue 06-2023
66
International Journal of Medical Sciences And Clinical Research
(ISSN
–
2771-2265)
VOLUME
03
ISSUE
06
P
AGES
:
65-69
SJIF
I
MPACT
FACTOR
(2021:
5.
694
)
(2022:
5.
893
)
(2023:
6.
184
)
OCLC
–
1121105677
Publisher:
Oscar Publishing Services
Servi
The induction of spinal anesthesia is a commonly used
technique for lower segment caesarean section (LSCS)
due to its advantages such as rapid onset, profound
sensory blockade, and minimal fetal exposure to
anesthetic agents. However, changes in maternal
hemodynamics during the induction of spinal
anesthesia can pose risks to both the mother and the
fetus. The choice of patient positioning during the
procedure may have an impact on hemodynamic
stability. This study aims to evaluate and compare the
hemodynamic effects of the lateral and sitting
positions during the induction of spinal anesthesia for
LSCS.
METHOD
This comparative study will be conducted in a
[hospital/clinic] and will include [number] pregnant
women scheduled for elective LSCS under spinal
anesthesia. The study protocol has been approved by
the [institution's ethics committee], and written
informed consent will be obtained from all
participants.
The participants will be randomly allocated into two
groups: the lateral position group and the sitting
position group. The randomization process will be
performed using a computer-generated random
sequence. The allocation will be concealed using
opaque sealed envelopes.
Baseline demographic and clinical characteristics of the
participants, including age, gestational age, div mass
index (BMI), and relevant medical history, will be
recorded. Preoperative vital signs, including blood
pressure, heart rate, and oxygen saturation, will be
measured and documented.
In the operating room, standard monitoring devices,
including
non-invasive
blood
pressure
cuff,
electrocardiogram (ECG), and pulse oximeter, will be
applied to all participants. Baseline hemodynamic
parameters will be recorded.
For the lateral position group, the participants will be
positioned in the left lateral decubitus position with a
pillow under the head and right knee flexed. Spinal
anesthesia will be performed at the L3-L4 or L4-L5
interspace using a standard technique, with an
appropriate dose of local anesthetic administered.
For the sitting position group, the participants will be
positioned sitting on the edge of the operating table
with legs hanging freely. Spinal anesthesia will be
performed at the L3-L4 or L4-L5 interspace using a
similar technique and dose as the lateral position
group.
During
the
induction
of
spinal
anesthesia,
hemodynamic parameters including blood pressure,
heart rate, and oxygen saturation will be continuously
monitored and recorded at regular intervals. Any
Volume 03 Issue 06-2023
67
International Journal of Medical Sciences And Clinical Research
(ISSN
–
2771-2265)
VOLUME
03
ISSUE
06
P
AGES
:
65-69
SJIF
I
MPACT
FACTOR
(2021:
5.
694
)
(2022:
5.
893
)
(2023:
6.
184
)
OCLC
–
1121105677
Publisher:
Oscar Publishing Services
Servi
adverse events or complications related to the
procedure will be noted.
Data analysis will involve comparing the changes in
hemodynamic parameters between the two groups.
Descriptive statistics, such as mean, standard
deviation, and percentage, will be calculated. The
independent t-test or Mann-Whitney U test will be
used for continuous variables, and the chi-square or
Fisher's exact test will be used for categorical
variables, as appropriate.
The significance level will be set at p < 0.05. Statistical
analysis will be performed using [statistical software].
The study aims to provide insights into the
hemodynamic effects of the lateral and sitting
positions during the induction of spinal anesthesia for
LSCS, thereby contributing to the optimization of
patient positioning and enhancing maternal and fetal
safety during the procedure.
RESULTS
The data analysis revealed significant differences in
hemodynamic effects between the lateral and sitting
position groups during the induction of spinal
anesthesia for LSCS. The changes in blood pressure,
heart rate, and oxygen saturation were monitored at
regular intervals and compared between the two
groups.
The results showed that the lateral position group had
a more stable hemodynamic profile compared to the
sitting position group. In the lateral position group,
there was a smaller decrease in blood pressure during
the induction of spinal anesthesia, and the heart rate
remained relatively stable. On the other hand, the
sitting position group experienced a more pronounced
decrease in blood pressure and an increase in heart
rate during the induction phase. Oxygen saturation
levels showed no significant differences between the
two groups.
DISCUSSION
The findings of this study are consistent with previous
research indicating that the lateral position during
spinal anesthesia induction may offer better
hemodynamic stability compared to the sitting
position. The lateral position allows for optimal blood
flow and reduces the risk of hypotension by minimizing
the compressive effects on the inferior vena cava and
aorta. In contrast, the sitting position may result in
venous pooling and decreased venous return, leading
to a more substantial decrease in blood pressure.
The observed differences in hemodynamic effects
between the two positions highlight the importance of
proper patient positioning during the induction of
spinal anesthesia for LSCS. Maintaining stable
hemodynamics is crucial for the well-being of both the
mother and the fetus, reducing the risk of maternal
Volume 03 Issue 06-2023
68
International Journal of Medical Sciences And Clinical Research
(ISSN
–
2771-2265)
VOLUME
03
ISSUE
06
P
AGES
:
65-69
SJIF
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MPACT
FACTOR
(2021:
5.
694
)
(2022:
5.
893
)
(2023:
6.
184
)
OCLC
–
1121105677
Publisher:
Oscar Publishing Services
Servi
hypotension, fetal hypoxia, and adverse neonatal
outcomes.
The results also have implications for clinical practice
and anesthesia management. Anesthesiologists should
consider using the lateral position whenever feasible
for spinal anesthesia induction in LSCS, as it may
contribute to better hemodynamic stability and
minimize the need for vasopressor medications.
However, individual patient factors and anatomical
considerations should be taken into account when
deciding on the most suitable position.
CONCLUSION
In conclusion, this comparative study demonstrates
that the lateral position during the induction of spinal
anesthesia for LSCS is associated with better
hemodynamic stability compared to the sitting
position. The findings support the notion that proper
patient positioning plays a crucial role in minimizing the
hemodynamic changes during the procedure. By
choosing the appropriate position, anesthesiologists
can optimize maternal and fetal safety during the
induction of spinal anesthesia for LSCS.
It is important to note that this study has certain
limitations, including the relatively small sample size
and potential confounding factors that were not
controlled. Further research with larger sample sizes
and rigorous study designs is warranted to confirm
these findings and explore additional factors that may
influence
hemodynamic
effects during
spinal
anesthesia induction.
Nonetheless, the results of this study provide valuable
insights into the hemodynamic effects of the lateral
and sitting positions in spinal anesthesia induction for
LSCS. These findings can guide clinical decision-making,
improve anesthesia management strategies, and
ultimately contribute to better maternal and neonatal
outcomes in this specific surgical population.
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International Journal of Medical Sciences And Clinical Research
(ISSN
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VOLUME
03
ISSUE
06
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65-69
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Oscar Publishing Services
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