Prevention of post-spinal hypotension at elective cesarean section by wrapping of the lower limbs.
OBJECTIVE
To investigate whether wrapping and/or elevation of the legs 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 no intervention. The outcome measures were the upper level of blockade, pulse rate and arterial systolic pressure (SAP). Statistical evaluation included paired and unpaired t-test, contingency table analysis and repeated measures analysis of variance.


RESULTS
The SAP remained significantly higher with wrapping; elevation did not add any benefit. The number of episodes of severe hypotension (defined as a SAP decrease > or = 20% of baseline and < 100 mmHg) was significantly reduced by wrapping (15.8% of cases) as compared to controls (45.5%)(chi2 = 11.02; P = 0.012). Elevation alone did not prevent hypotension (chi2 = 0.76; P = 0.38).


CONCLUSIONS
Wrapping of the legs at spinal block for Cs is recommended to reduce hypotension.
van Bogaert
L J
LJ
Department of Obstetrics and Gynecology, University of Transkei, Philadelphia Hospital, Dennilton, South Africa.
D000328:Adult; D000704:Analysis of Variance; D000773:Anesthesia, Obstetrical / Q000009:adverse effects; D000775:Anesthesia, Spinal / Q000009:adverse effects*; D001458:Bandages; D002585:Cesarean Section / Q000379:methods; D017558:Elective Surgical Procedures; D005260:Female; D006801:Humans; D007022:Hypotension / Q000209:etiology / Q000517:prevention & control*; D007866:Leg; D011187:Posture; D011247:Pregnancy; D016896:Treatment Outcome