The Effect of Reverse Trendelenburg Position on Incidence of Hypotension after Spinal Anesthesia for Cesarean Section

Chuthit Keesakul MD*, Prissana Sae-Ngow MD*, Panteera Euaraksakul MD*, Cherdkiat Karnjanarachata MD*

Affiliation : * Department of Anesthesiology, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand

Objective : To prove if 10-degree head-up tilt position during conduction of spinal anesthesia and continue through the operation will reduce the incidence of hypotension comparing to horizontal position in elective cesarean section parturient. Material and Method: In this randomized double-blind controlled trial. Forty-four parturient were equally allocated into 10-degree head-up tilt and horizontal position during conduction of spinal anesthesia and continue during the operation. Blood pressure, heart rate, incidence of hypotension, ephedrine consumption, and anesthesia level were compared.
Results : Incidence of hypotension and percentage of parturient that required ephedrine were comparable in control and study groups (72.73% vs. 45.45%, p = 0.066) but lower before cord clamping in the study group (68.18% vs. 36.36%, p = 0.03). The sensory block levels were identical but more parturient in the study group required reposition in order to gain the required anesthetic level.
Conclusion : Ten-degree head-up tilt position during conduction and maintenance of spinal anesthesia for cesarean section reduced incidence of hypotension and ephedrine consumption without any adverse effect in both parturient and newly-born babies.

Keywords : Spinal anesthesia, Cesarean section, Position, Head-up tilt, Hypotension

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