A Sequential Compression Mechanical Pump to Prevent Hypotension During Elective Cesarean Section Under Spinal Anesthesia

Sujata, Nambiath; Arora, Deep; Panigrahi, Bishnu; Hanjoora, Vijay Mohan

doi:10.1097/01.aoa.0000429151.31144.97

Cited by 4 publications

(6 citation statements)

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“…We included 109 out of 1021 retrieved trials, which included 8561 women (Fig. and see also Supporting Information, Table S1) . Twelve interventions (eleven active treatments and one inactive control) to prevent intra‐operative hypotension were studied, with 30 direct comparisons (see also Supporting Information, Table S2).…”

Section: Resultsmentioning

confidence: 99%

Prevention of hypotension after spinal anaesthesia for caesarean section: a systematic review and network meta‐analysis of randomised controlled trials

et al. 2019

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Summary Spinal anaesthesia for caesarean section commonly causes maternal hypotension. This systematic review and network meta‐analysis compared methods to prevent hypotension in women receiving spinal anaesthesia for caesarean section. We selected randomised controlled trials that compared an intervention to prevent hypotension with another intervention or inactive control by searching MEDLINE and Embase, Web of Science to December 2018. There was no language restriction. Two reviewers extracted data on trial characteristics, methods and outcomes. We assessed risk of bias for individual trials (Cochrane tool) and quality of evidence (GRADE checklist). We assessed 109 trials (8561 women) and 12 different methods that resulted in 30 direct comparisons. Methods ranked by OR (95%CI) from most effective to least effective were: metaraminol 0.11 (0.04–0.26); norepinephrine 0.13 (0.06–0.28); phenylephrine 0.18 (0.11–0.29); leg compression 0.25 (0.14–0.43); ephedrine 0.28 (0.18–0.43); colloid given before induction of anaesthesia 0.38 (0.24–0.61); angiotensin 2, 0.12 (0.02–0.75); colloid given after induction of anaesthesia 0.52 (0.30–0.90); mephentermine 0.09 (0.01–1.30); crystalloid given after induction of anaesthesia 0.78 (0.46–1.31); and crystalloid given before induction of anaesthesia 1.16 (0.76–1.79). Phenylephrine caused maternal bradycardia compared with control, OR (95%CI) 0.23 (0.07–0.79). Ephedrine lowered umbilical artery pH more than phenylephrine, standardised mean difference (95%CI) 0.78 (0.47–1.49). We conclude that vasopressors should be given to healthy women to prevent hypotension during caesarean section with spinal anaesthesia.

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Section: Resultsmentioning

confidence: 99%

Prevention of hypotension after spinal anaesthesia for caesarean section: a systematic review and network meta‐analysis of randomised controlled trials

et al. 2019

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“…studied the effect of sequential compression mechanical pump with thigh-high sleeves with compression cycles timed to venous refilling. [ 15 ] In their study, they found that the incidence of hypotension was lower (25.5%) than controls (50%) ( P < 0.0001). They concluded that the use of a sequential compression mechanical pumps that detect venous refilling and cycles accordingly, reduced the incidence and severity of hypotension after spinal anesthesia for cesarean sections.…”

Section: Discussionmentioning

confidence: 92%

“…This finding is in accordance with the previous studies. [ 12 13 14 15 ] Rout et al . had done a study in 97 parturients who were randomized into three groups; one group received leg elevation and wrapping, second group received leg elevation alone, and third group received none.…”

Section: Discussionmentioning

confidence: 99%

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Hemodynamic changes under spinal anesthesia after elastic wrapping or pneumatic compression of lower limbs in elective cesarean section: A randomized control trial

Prajith

Mishra

Ravishankar

et al. 2020

J Anaesthesiol Clin Pharmacol

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Background and Aims: In spite of adequate fluid loading and left lateral tilt, parturients develop hypotension under spinal anesthesia during cesarean section. Elastic crepe bandage (CB) or pneumatic compression device (PCD) can be utilized to prevent the pooling of blood in lower limbs and thereby it may reduce the incidence of hypotension in these patients. This study was formulated to analyze the hemodynamic effects of leg wrapping with elastic CB and PCD in parturients undergoing for cesarean section under anesthesia. Material and Methods: Ninety term obstetric patients posted for elective cesarean section under spinal anesthesia were randomized into 3 groups: Group 1 (control), Group 2 (CB), and Group 3 (PCD). All the parturients had their legs wrapped with an elastic bandage and pneumatic sleeve applied over it. In Group 1 (Control), patients had their legs wrapped with CB loosely and pneumatic sleeve also applied was switched on. In Group 2, patients the CB was applied by stretching the bandage (15 cm width and 4 m stretched length). The PCD was not switched on in this group. In Group 3, the legs were wrapped with the CB loosely. The pneumatic sleeve was applied over the bandage, and the machine was switched on with a preset pressure of 40–50 mmHg after spinal anesthesia. Incidence of maternal hypotension and ephedrine requirement to maintain systolic blood pressure, neonatal Apgar score were recorded. Results: The incidence of hypotension was significantly lower in Group 2 and 3 than the control group. Similarly, the requirement of ephedrine was significantly high in control group compared to CB and PCD. The incidence of hypotension was lower in group CB than group PCD. Meantime to receive the first dose of ephedrine was significantly low in control (7.37 ± 4.94 min) as compared to CB (10 ± 2.8 min) and PCD (13.88 ± 9.23). Conclusion: Leg-wrapping with CB is cost-effective, non-invasive, non-pharmacological, and effective tool to reduce the incidence of hypotension after spinal anesthesia in a parturient.

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“…It is being a simple, nonpharmacological and cost-effective technique can be used on a daily basis to prevent hypotension. (Sujata N, Arora D, Panigrahi BP, Hanjoora VM 2012).…”

Section: Introductionmentioning

confidence: 99%

Effectiveness of Lower Leg Compression Maneuver in Reducing Spinal Anesthesia Induced Hypotension for Women Undergoing Cesarean Section

Elati

Elshahat

Ali

et al. 2020

Port Said Scientific Journal of Nursing

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A Sequential Compression Mechanical Pump to Prevent Hypotension During Elective Cesarean Section Under Spinal Anesthesia

Cited by 4 publications

References 0 publications

Prevention of hypotension after spinal anaesthesia for caesarean section: a systematic review and network meta‐analysis of randomised controlled trials

Prevention of hypotension after spinal anaesthesia for caesarean section: a systematic review and network meta‐analysis of randomised controlled trials

Hemodynamic changes under spinal anesthesia after elastic wrapping or pneumatic compression of lower limbs in elective cesarean section: A randomized control trial

Effectiveness of Lower Leg Compression Maneuver in Reducing Spinal Anesthesia Induced Hypotension for Women Undergoing Cesarean Section

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