The Trendelenburg position increases the spread and accelerates the onset of epidural anesthesia for Cesarean section

Purpose: The effect of position on the spread and the onset time of epidura l anesthesia has not been well documented. This study was undertaken to ass ess the effect of modified Trendelenburg position on the spread of epidural anesthesia for Cesarean section. Methods: Seven hundred thirty-nine parturients underwent epidural anesthesi a for elective or emergent Cesarean section. Patients were divided into two groups in a randomized-controlled study. All patients received 20 mL of 2% lidocaine injected through a 19G epidural needle, a standard technique in our institution, During induction of epidural anesthesia, the first group w as placed in 15 Trendelenburg with 10 head-up position and the second in th e horizontal position. The onset time and the level of anesthesia, patients ' vital signs, and Apgar score were recorded in both groups. Results. There were no significant differences in vital signs, oxygen satur ation and Apgar score between the two groups. The results show significant differences in the time of onset (on overage four minutes foster in the mod ified Trendelenburg position group) (P < 0.001), and in achieving T5 level sensory blockade (97.5% vs 42.8%) between the modified Trendelenburg and ho rizontally positioned pregnant women, Conclusion: This study demonstrates that the modified Trendelenburg positio n has a significant effect on the spread and the onset time of single shot epidural anesthesia, and can be used safety in term parturients for emergen cy or elective Cesarean section.