PREVENTION OF POST-SPINAL HYPOTENSION AT ELECTIVE CESAREAN-SECTION BYWRAPPING OF THE LOWER-LIMBS

Objective: To investigate whether wrapping and/or elevation of the leg s prevents post-spinal hypotension at cesarean section (CS). Methods: 82 parturients in a community hospital were randomly allocated to one of 4 groups: raising, wrapping, raising and wrapping of the legs and n o intervention. The outcome measures were the upper level of blockade, pulse rate and arterial systolic pressure (SAP). Statistical evaluati on included paired and unpaired t-test, contingency table analysis and repeated measures analysis of variance. Results: The SAF remained sig nificantly higher with wrapping; elevation did not add any benefit. Th e number of episodes of severe hypotension (defined as a SAP decrease greater than or equal to 20% of baseline and < 100 mmHg) was significa ntly reduced by wrapping (15.8% of cases) as compared to controls (45. 5%)(chi(2) = 11.02; P = 0.012). Elevation alone did not prevent hypote nsion (chi(2) = 0.76; P = 0.38). Conclusion: Wrapping of the legs at s pinal block for Cs is recommended to reduce hypotension. (C) 1998 Inte rnational Federation of Gynecology and Obstetrics.