title: [Prevention of spinal hypotension associated with cesarean section by aortocaval compression--left 15 degree table tilt vs. uterine displacement by hand].
abstract: Women undergoing elective cesarean delivery were randomly assigned to receive a spinal anesthesia in either the semi-lateral (group SL) position or the supine position with uterine displacement (group UD). After spinal injection, group SL patients were turned to a 15 degrees left lateral supine position, and group UD patients had uterine displacement by hand. Ephedrine 4 mg i.v. was administered in case of nausea/vomiting and/or hypotension, defined as a systolic blood pressure below 100 mmHg. Arm systolic arterial pressure and leg systolic arterial pressure were similar in both groups, but the lowest leg systolic arterial pressure until delivery was significantly lower in the UD group (P < 0.05). Mean ephedrine requirement was significantly less in the SL group (P < 0.05). Apgar scores did not differ, but umbilical artery pH values were significantly higher in patients of the group SL (P < 0.01).
authors.affiliation: Department of Anesthesiology and Pain Medicine, Juntendo University School of Medicine Urayasu Hospital, Urayasu 279-0021.
authors.forename: Kunitomo
authors.initials: K
authors.lastname: Kashiwagi
authors.forename: Kumi
authors.initials: K
authors.lastname: Kataoka
authors.forename: Saiko
authors.initials: S
authors.lastname: Wakabayashi
authors.forename: Yuko
authors.initials: Y
authors.lastname: Kumagawa
authors.forename: Eri
authors.initials: E
authors.lastname: Morimoto
authors.forename: Tsuyoshi
authors.initials: T
authors.lastname: Maeda
authors.forename: Tomonari
authors.initials: T
authors.lastname: Kamiyama
authors.forename: Kouji
authors.initials: K
authors.lastname: Watanabe
authors.forename: Yasushi
authors.initials: Y
authors.lastname: Kawauchi
authors.forename: Akio
authors.initials: A
authors.lastname: Mizushima
authors.forename: Youichirou
authors.initials: Y
authors.lastname: Kamiyama
mesh_terms: D000773:Anesthesia, Obstetrical; D000775:Anesthesia, Spinal; D001012:Aorta, Abdominal / Q000473:pathology; D001034:Apgar Score; D002585:Cesarean Section; D017558:Elective Surgical Procedures; D004809:Ephedrine / Q000008:administration & dosage; D005260:Female; D006801:Humans; D007022:Hypotension / Q000517:prevention & control*; D007231:Infant, Newborn; D007431:Intraoperative Complications / Q000517:prevention & control*; D011187:Posture; D011247:Pregnancy; D014684:Venae Cavae / Q000473:pathology
chemical_list: D004809:Ephedrine