title: The effect of 10 degrees head-up tilt in the right lateral position on the systemic blood pressure after subarachnoid block for Caesarean section.
abstract: Forty women presenting for elective Caesarean section under spinal anaesthesia were randomly assigned to have anaesthesia induced in the right lateral position either in the horizontal position or with 10 degrees head-up tilt. Hyperbaric bupivacaine 2 ml 0.5% with 0.1 mg of morphine was injected intrathecally before the parturients were placed in the supine position with 15 degrees left lateral tilt. Blood pressure and heart rate were monitored every minute and the sensory level (loss of sharp sensation to pinprick) was monitored every 3 min until clamping of the umbilical cord. Ephedrine 6 mg was given every minute that the systolic blood pressure decreased below 90 mmHg. The mean systolic blood pressure during the first 5 min after induction of spinal anaesthesia was lower in the control group compared to the tilted group (99 mmHg vs. 109 mmHg; p = 0.043). The upper limit of block was higher in the control group compared to the tilted group (p = 0.002). The use of 10 degrees head-up tilt resulted in a reduced incidence of hypotension initially and less extensive sensory block.
authors.affiliation: Department of Anaesthesia (Obstetrics & Gynaecology), KK Women's and Children's Hospital, 100 Bukit Timah Road, Singapore 229899.
authors.forename: G P Y
authors.initials: GP
authors.lastname: Loke
authors.forename: E H Y
authors.initials: EH
authors.lastname: Chan
authors.forename: A T H
authors.initials: AT
authors.lastname: Sia
mesh_terms: D000328:Adult; D000773:Anesthesia, Obstetrical / Q000009:adverse effects / Q000379:methods*; D000775:Anesthesia, Spinal / Q000009:adverse effects / Q000379:methods*; D000779:Anesthetics, Local; D001794:Blood Pressure / Q000502:physiology*; D002045:Bupivacaine; D002585:Cesarean Section; D004334:Drug Administration Schedule; D004809:Ephedrine / Q000008:administration & dosage; D005260:Female; D006801:Humans; D007022:Hypotension / Q000209:etiology; D011187:Posture / Q000502:physiology*; D011247:Pregnancy; D014662:Vasoconstrictor Agents / Q000008:administration & dosage
chemical_list: D000779:Anesthetics, Local; D014662:Vasoconstrictor Agents; D004809:Ephedrine; D002045:Bupivacaine