Sequential compression device with thigh-high sleeves supports mean arterial pressure during Caesarean section under spinal anaesthesia.
BACKGROUND
This study investigated the use of a Sequential Compression Device (SCD) with thigh-high sleeves and a preset pressure of 50 mm Hg that recruits blood from the lower limbs intermittently, as a method to prevent spinal hypotension during elective Caesarean section. Possible association of arterial pressure changes with maternal, fetal, haemodynamic, and anaesthetic factors were studied.


METHODS
Fifty healthy parturients undergoing elective Caesarean section under spinal anaesthesia were randomly assigned to either SCD (n=25) or control (n=25) groups. A standardized protocol for pre-hydration and anaesthetic technique was followed. Hypotension was defined as a decrease in any mean arterial pressure (MAP) measurement by more than 20% of the baseline MAP. Systolic (SAP), MAP and diastolic (DAP) arterial pressure, pulse pressure (PP), and heart rate (HR) were noted at baseline and every minute after the spinal block until delivery.


RESULTS
A greater than 20% decrease in MAP occurred in 52% of patients in the SCD group vs 92% in the control group (P=0.004, odds ratio 0.094, 95% CI 0.018-0.488). There were no significant differences in SAP, DAP, HR, and PP between the groups.


CONCLUSIONS
SCD use in conjunction with vasopressor significantly reduced the incidence of a 20% reduction of MAP.
Department of Anesthesiology, School of Medicine, State University Of New York, Stony Brook, NY 11794-8480, USA. radsumelli@anesthes.sunysb.edu
R S N
RS
Adsumelli
E S
ES
Steinberg
J E
JE
Schabel
T A
TA
Saunders
P J
PJ
Poppers
D000773:Anesthesia, Obstetrical / Q000009:adverse effects* / Q000379:methods; D000775:Anesthesia, Spinal / Q000009:adverse effects*; D001794:Blood Pressure; D002585:Cesarean Section; D003250:Constriction; D005260:Female; D006439:Hemodynamics; D006801:Humans; D007022:Hypotension / Q000209:etiology / Q000517:prevention & control*; D007431:Intraoperative Complications / Q000517:prevention & control*; D011247:Pregnancy; D016037:Single-Blind Method; D013848:Thigh