title: Maternal position and development of hypotension in patients undergoing cesarean section under combined spinal-epidural anesthesia of intrathecal hyperbaric ropivacaine.
abstract: BACKGROUND
  Spinal anesthesia (SA) is usually associated with hypotension in pregnant women. We sought to assess the influence of various maternal positions on SA-induced hypotension
  
  
  METHODS
  The study population comprised 99 women at full-term gestation scheduled for elective cesarean section. They were randomized into 3 equal groups: the LL group, in which the patient was placed in the full left-lateral position until the start of surgery with the Whitacre needle bevel oriented laterally; the LS group, in which the patient was placed in the full left-lateral position initially and then shifted to the left-tilt supine position with the needle bevel oriented laterally; and the CS group, in which the patient was initially placed in the full left-lateral position and then shifted to the left-tilt supine position with the needle oriented in the cephalad direction.
  
  
  RESULTS
  The incidences of hypotension in the LL, LS, and CS groups were 9.7%, 54.8%, and 56.3%, respectively. Ephedrine requirements were lower in the LL group than in the LS group (P<0.01).
  
  
  CONCLUSIONS
  The maternal position during the induction of anesthesia played an important role in the development of hypotension during cesarean delivery.
authors.affiliation: Department of Anesthesiology, The Second Xiangya Hospital, Central South University, Changsha, China (mainland).
authors.forename: Xin
authors.initials: X
authors.lastname: Wang
authors.affiliation: Department of Anesthesiology, The Second Xiangya Hospital, Central South University, Changsha, China (mainland).
authors.forename: Jun-Mei
authors.initials: JM
authors.lastname: Xu
authors.affiliation: Department of Anesthesiology, The Second Xiangya Hospital, Central South University, Changsha, China (mainland).
authors.forename: Fan
authors.initials: F
authors.lastname: Zhou
authors.affiliation: Department of Anesthesiology, The Second Xiangya Hospital, Central South University, Changsha, China (mainland).
authors.forename: Liang
authors.initials: L
authors.lastname: He
authors.affiliation: Department of Anesthesiology, The Second Xiangya Hospital, Central South University, Changsha, China (mainland).
authors.forename: Yu-Long
authors.initials: YL
authors.lastname: Cui
authors.affiliation: Department of Anesthesiology, The Second Xiangya Hospital, Central South University, Changsha, China (mainland).
authors.forename: Zhi-Jian
authors.initials: ZJ
authors.lastname: Li
mesh_terms: D000328:Adult; D000577:Amides / Q000008:administration & dosage*; D000767:Anesthesia, Epidural / Q000009:adverse effects / Q000379:methods*; D000775:Anesthesia, Spinal / Q000009:adverse effects / Q000379:methods*; D000779:Anesthetics, Local / Q000009:adverse effects; D001794:Blood Pressure; D002585:Cesarean Section / Q000379:methods*; D005260:Female; D006439:Hemodynamics; D006801:Humans; D007022:Hypotension / Q000209:etiology*; D009407:Nerve Block; D011247:Pregnancy; D000077212:Ropivacaine; D016683:Supine Position / Q000502:physiology*; D014599:Uterus / Q000098:blood supply*
chemical_list: D000577:Amides; D000779:Anesthetics, Local; D000077212:Ropivacaine