Comparison of 1-and 2- Minute Sitting Position Versus Immediately Lying Down of Hemodynamic Variables after Spinal Anesthesia with Hyperbaric Bupivacaine in Elective Cesarean Section


Dr. Ahmed Salam Dawood
M.B.Ch.B./FICMS A&IC/Al Shaheed Dr.Fairuz Hospital/Wasit Health Directory/ Ministry of Health and Environment, Iraq.
Dr. Aimen Hameed Latef, Assist.Prof.
M.B.Ch.B./DA/FICMS A&IC/Consultant Anesthetist.


the aim of current study: was Comparison of 1-and 2- minute sitting position versus immediately lying down on hemodynamic variables after spinal anesthesia with hyperbaric bupivacaine in elective cesarean section. Patients and methods: This study was performed after the approval of the Iraqi Council for Medical Specialization in anesthesia and intensive care, and after obtaining the consents from 90 pregnant women (at term) who were candidate for cesarean section with spinal anesthesia were recruited in this study. They were collected from “AL-Imamain AL-Kademain Medical City Teaching Hospital” (July 2017 – January 2018) , All patients were premedicated with 10mg IV metoclopramide and 50mg IV ranitidine , Base line blood pressure and the pulse rate were recorded initially before intervention , the Lumbar puncture was performed in the sitting position under full aseptic teqnique , For assessment of blood pressure and pulse rate, ten readings were taken at (3, 5, 10, 15, 20, 25, 30, 35,40and 60 min) using an automated noninvasive blood pressure. Pulse rate monitored by electrocardiogram and oximetry (SPO2). Results: Current study showed higher means of pulse rate than the other two groups especially at early times after anesthesia induction. On the other hand, both group A1 and A2 showed higher mean of systolic, diastolic and mean blood pressure than group B especially 3, 5, 10 and 15 minutes after anesthesia induction, so the variation of pulse rate over the time in the three groups. Group B had higher pulse rate Journal of University of Shanghai for Science and Technology ISSN: 1007-6735 Volume 23, Issue 9, September – 2021 Page-7882 than the other two groups at 3,5,10, 25 and 40 minutes with significant difference (P8 in all groups. Conclusions: This study revealed that the patient’s position is an important factor, which affects the frequency of Hypotension and the onset of sensory block , as well as Administration of spinal anesthesia for cesarean section. Based on the findings, keeping the parturient seated for 1 Or 2 minutes after spinal anesthesia, compared to immediately lying down, could decrease the frequency of hypotension.