Does Leg Raising Prevent Spinal-Induced Hypotension in Elective Cesarean Sections? A Randomized Controlled Study

Abstract

Objective: We aimed to investigate the effectiveness of the leg raising (LR) method in preventing spinal anesthesia-induced hypotension in elective cesarean section (C/S) operations. Methods: One hundred and forty term pregnant women were included in the study. The patients were divided into two groups as leg raising group (Group L, n=70) and the control group (Group C, n=70). After spinal anesthesia, a cushion was placed under the heels of the patients in Group L at an angle of 30 degrees with the horizontal plane. No intervention was made in Group C. The patients’ hemodynamic and operation data were recorded at determined intervals. Results: In Group L, hypotension was observed in 29 (41.4%) patients while 54 (77.1%) patients developed hypotension in Group C (p<0.001). Systolic and diastolic blood pressure values at the 2nd and 3rd minutes after spinal anesthesia were found to be higher in Group L (p<0.05). Furthermore, compared to Group C, the amount of ephedrine used in Group L was found to be lower (9.9±14.2 mg vs. 15.9±11.9 mg, p=0.007). Conclusion: The LR method applied in C/S operations reduces spinal anesthesia-induced hypotension and thus causes the need for less vasopressor. Keywords: Cesarean section, spinal anesthesia, leg raising, hypotension

Effectiveness of Leg-Elevation to Prevent Post-Spinal Hypotension in Elective Cesarean Section: A Systematic Literature Review of Randomized Controlled Trial

“…This finding is consistent with the findings of the study performed by Hasanin et al 23 The incidence of hypotension was lower in the LR group than in the control group in the study by Mustafa Deniz Sari et al, similar to Hasanin and Assen, applying LR at an angle of 30 degrees with the horizontal plane (41.4% vs 77.1%, p = 0.001). 24 In contrast to the control group, the leg elevation group had a decreased incidence of post-spinal hypotension. This randomised controlled experiment shows that, with a P value of 0.05, the incidence of post-spinal hypotension is 26 (34.7%) in the leg elevation group and 44 (58.7%) in the control group.…”

Postspinal Anesthesia Hypotension in Caesarean Delivery: A Narrative Review

“…Similar to Hasanin and Assen, the incidence of hypotension was reduced in the LR group compared to the control group in the Sari et al study (p = 0.001) [ 60 ]. LR was applied at a 30° angle with the horizontal plane [ 60 , 61 ].…”