Lateral versus sitt ing positions during induction of spinal anaesthesia for elective caesarean section: A Comparative Study

Abstract

Introduction: Th ere is a rapid increase in cesarean section rates throughout the world. Positioning of patients before giving spinal anesthesia has been a topic of immense interest amongst anesthesiologists. Many authors have investigated postures such as left lateral and right lateral positions as well sitt ing positions during induction of spinal anesthesia and studied the eff ect of postures on parameters such as spread of sensory blockade, occurrence of hypotension, and incidence of post Dural Puncture Headache. We conducted this comparative study to analyse the eff ect of positioning (sitt ing versus lateral) on sensory and motor blockade as well as on hemodynamic stability and incidence of post dural puncture headache (PDPH). Materials and Methods: 90 women posted for elective cesarean section and belonging to ASA I and II from 1st March 2015 till 28 February 2017 were included in this study on the basis of a predefi ned inclusion and exclusion criteria. Out of 90 studied cases 45 patients were given Spinal Anesthesia in sitt ing position (group-A) whereas in remaining 45 patients induction of spinal was done in left lateral decubitus position (group-B). Th e eff ect of positioning (sitt ing versus lateral) on sensory and motor blockade as well as on hemodynamic stability and incidence of PDPH was compared in studied cases. P value less than 0.05 was taken as statistically signifi cant. Results: Demographic factors such as mean age and weight and ASA grades of the studied cases were found to be comparable with no statistically signifi cant diff erence between the studied groups (P>0.05). Sensory blockade at 5 minutes and motor blockade at 3 minutes was found to be statistically signifi cantly diff erent in both the groups. Th ere was a drop in mean arterial pressure in patients of sitt ing group aft er they were given supine position which is refl ected in the readings at 5,10 and 15 minutes. 9 patients in sitt ing group and 2 patients in lateral group had bothersome headache. Th e diff erence was found to be statistically signifi cant (P<0.05). Conclusion: Lateral decubitus position as compared to sitt ing position while doing induction of spinal anesthesia appears to be a bett er choice for patients undergoing elective cesarean section.