Effect of left tilt of operating table during elective caesarean section on maternal haemodynamics and vasopressor requirement.
Keywords:Aortocaval Compression, Caesarean Section, Hypotension, Left Tilt Position, Phenylephrine, Vasopressor
Objective: To compare the effects of left tilt of operating table on maternal hemodynamics and vasopressor requirement in contrast to supine position during caesarean section. Study Design: Comparative Analytical Study. Setting: District Head Quarter Hospital, Rawalpindi. Period: December 2021 to February 2022. Material & Methods: A total of 38 participants were included by the lottery method of randomization into the two groups according to the inclusion and exclusion criteria: supine group and left tilt group. For Supine Group, spinal anesthesia was administered in the sitting position, and then supine position was maintained. For Left tilt group, spinal anesthesia was administered in the sitting position and was then maintained in the supine position until the full anesthetic effect was achieved, and the table was tilted 15 °to the left. The Systolic and the diastolic blood pressures were noted at regular intervals. Data were entered and analyzed using SPSS version 25. Results: The results showed that systolic blood pressure decreased significantly in the supine group (F= 16.65, p< 0.000) compared to the left-tilted group (F= 2.1, p= 0.12). Intraoperative phenylephrine was required by four out of 20 participants in the supine group after 10 and 15 minutes, of out 2/20 participants after 20 minutes and out of 6/18 participants after 30 minutes. None of the participants in the left-tilt group required intraoperative phenylephrine. Conclusion: The left tilted position of the operating table is better than the supine position in terms of maternal hemodynamics and vasopressor requirement during Caesarean section.
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