Can Passive Leg Raise Prevent Spinal Anesthesia-induced Hypotension During Cesarean Section?

Antalya Training and Research Hospital

Status: Completed

Conditions: Hypotension

Treatments: Other: control; Other: Passive leg Raise

Study type: Interventional

Funder types: Other

Identifiers

NCT04673253

AntalyaEAH03

Details and patient eligibility

About

All over the world, spinal anesthesia is widely used in cesarean sections due to its superiority over general anesthesia. Due to reasons such as increased sensitivity to local anesthetics and increased intra-abdominal pressure in pregnant women, the frequency of hypotension increases by up to 70%. As a result of the blockage of sympathetic vasoconstrictor fibers originating from T1-L2 segments, loss of peripheral resistance, venous ponding occurs, and cardiac output decreases. Also, the level required for cesarean operation is T4 or T5, and the possibility of affecting the cardiac accelerator fibers, so bradycardia due to the increase in parasympathetic activity may deepen the hypotension. If postspinal hypotension is not managed correctly, it may lead to maternal and fetal complications. In addition to classical methods such as fluid loading and prophylactic vasoconstrictor application to prevent hypotension in pregnant women after spinal anesthesia, techniques such as wrapping the lower extremity, lifting, or applying both together have been in question.

Passive leg raise application is an easy method that allows the blood collected in the lower part of the body to participate in the central circulation with the effect of gravity. An increase in venous return occurs with the passage of blood from the lower extremities to the thorax. Thus, it leads to an increase in stroke volume and an increase in cardiac output. In this study, we aimed to determine the effectiveness of passive leg raising in preventing or reducing the depth of hypotension after spinal anesthesia in pregnant women who underwent cesarean section under spinal anesthesia.

Enrollment: 140 patients

Sex: Female

Ages: 18 to 40 years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• Parturients who are planned for the elective cesarean section

Exclusion criteria

• Failed spinal block
• Shift to general anesthesia
• Severe cardiac disease
• Hypertensive disorders of pregnancy

Trial design

Primary purpose: Prevention

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: Single Blind

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140 participants in 2 patient groups, including a placebo group

Passive leg raise

Active Comparator group

Description:

group for passive leg raise

Treatment:

Other: Passive leg Raise

Control

Placebo Comparator group

Treatment:

Other: control