Lower limb elevation in prevention of spinal anesthesia (SA)- induced maternal hypotension in elective Cesarean section (C/S): a randomized double blind clinical trial

Hypotension is a common complication of spinal anesthesia during cesarean section that available treatments do not completely eliminate this complication. Due to the low cost and ease of legs elevation, this study was performed with aim to evaluate the effect of leg's raising on reducing the incidence of maternal hypotension.

This double-blind randomized clinical trial study was performed in 2019-2020 on 101 pregnant women who were candidates for c/s under spinal anesthesia in Fatemiyeh Hospital of Hamadan University of Medical Sciences. The subjects were randomly assigned to the intervention group (raising legs after anesthesia) and control group (without raising legs). After the onset of anesthesia and at different times, systolic and diastolic blood pressure, the incidence of hypotension, bradicardia, nausea, vomiting and used atropin or ephedrin were recorded and compared in the two study groups. Data were analyzed by SPSS software (version 22) and Independent t-test and Chi square test. P<0.05 was considered statistically significant.

No significant difference was observed between the two groups in terms of mean systolic and diastolic blood pressure and heart rate at different times (P>0.05) and only the mean diastolic BP at 25 minutes was lower in the intervention group than the control group (P≤0.05). The incidence of nausea and vomiting was always lower in the intervention group than the control group, but the difference was not significant (P>0.05). The incidence of hypotension was 54% in the intervention and 60.8% in the control group, but the difference was not significant (P = 0.5).

The leg's raising after spinal anesthesia has no significant effect on hemodynamics indices including the occurrence of hypotension.