Evaluation of leg wrapping for the prevention of postspinal hypotension in cesarean section under spinal anesthesia

Abstract

Background:Spinal blockade provides excellent anesthesia for patients undergoing cesarean section. However, hypotension after spinal anesthesia is a common adverse effect that is commonly experienced in patients undergoing cesarean section. The aim of our study was to analyze if a simple technique like leg wrapping with elastic crepe bandage would be effective in controlling postspinal hypotension.Materials and Methods:Sixty full-term pregnant patients who were posted for cesarean section belonging to American Society of Anesthesiologists I and II were divided into two groups. Patients in Group W had their legs wrapped with elastic crepe bandage and in the other Group N, leg wrapping was not done. All the patients were preloaded with Ringer lactate at 10 ml/kg before the spinal anesthesia. The hemodynamic parameters were monitored every 3 min until the delivery of the baby and every 5 min until the end of surgery. If hypotension occurred, then along with crystalloid loading a bolus dose of mephentermine 6 mg was given intravenously.Statistical Analysis:Statistical software “Numbers version 3.6.1 (2566)” was used for statistical calculations.Results:Frequency of hypotension in Group W (10%) was significantly less compared to Group N (60%). Vasopressor requirement was significantly less in Group W (P = 0.009), which was highly significant.Conclusion:Wrapping of lower extremities was a simple, easy, and an effective method of decreasing episodes of hypotension and vasopressor requirement after spinal anesthesia in cesarean patients and needs to be practiced routinely.

Effect of lower leg compression during cesarean section on post-spinal hypotension and neonatal hemodynamic parameters: nonrandomized controlled clinical trial

“…This finding is consistent with Bagle et al., Das and Swain, and Singh et al. The first indicated that vasopressor requirement was significantly lower in leg-wrapped group, which was highly significant [12]. The second found that 10% among his participants required rescue phenylephrine compared with 50% the control group, which is statistically significant [13].…”

“…Second, Bagle et al. in USA studied “evaluation of leg wrapping for the prevention of PSH in cesarean section under spinal anesthesia.” They reported that hypotension attacks occurred in 60% of the control group compared with only 10% of the leg compression group with steady higher MAP in the intervention group during the operation [12]. Third, Mohamed et al.…”

“…reported no significant changes between study and control groups in relation to HR. They elaborated some HR variation observed after taking vasopressors drugs [12]. Kuhn et al.…”

Effect of leg wrapping technique on prevention of spinal induced hypotension and fetal acidosis during cesarean section: Randomized controlled trial

“…Leg wrapping is nursing procedure and is difficult to be compared with medications, which have systemic effect. Also, Bagle et al [17] who reported no significant changes between study and control groups regarding heart rate for Indian pregnant women. They explained that some heart rate variation noted after vasopressors administration.…”

“…Mohamed et al; [12] Das & Swain. ; [14] Elgzar & Ebrahim; [16] Bagle et al [17] who found that wrapping of lower limbs just before spinal anesthesia is an effective technique to decrease frequency of severe hypotension episodes and dose requirement of vasopressor used, a difference which was significant, both clinically and statistically.…”