抬高腿部预防资源有限地区剖宫产术中脊髓麻醉所致低血压的有效性：开放性随机对照试验

Effectiveness of Leg Elevation to Prevent Spinal Anesthesia-Induced Hypotension during Cesarean Delivery in the Resource-Limited Area: Open Randomized Controlled Trial.

作者信息

Assen Sofia, Jemal Bedru, Tesfaye Adane

机构信息

Department of Anesthesia, College of Medicine and Health Sciences, Dilla University, Dilla, Ethiopia.

Department of Public Health, College of Medicine and Health Sciences, Dilla University, Dilla, Ethiopia.

出版信息

Anesthesiol Res Pract. 2020 Aug 24;2020:5014916. doi: 10.1155/2020/5014916. eCollection 2020.

DOI:10.1155/2020/5014916

PMID:32908497

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC7463362/

Abstract

BACKGROUND

Postspinal hypotension is the most common complication after spinal anesthesia for cesarean section (CS). Hypotension mainly occurs due to the reductions of vascular tone leading to decreased systemic vascular resistance and decreased venous return. The aim of this study was to assess the effectiveness of leg elevation (LE) as a method of prevention of postspinal hypotension in patients who undergo cesarean section under spinal anesthesia.

METHODS

This is a single-center parallel-randomized controlled trial study, and 52 full-term parturients scheduled for elective cesarean section who meets inclusion criteria were included in the study. The randomization sequence was created by a researcher not participating in patient management using a computer random generator. The participant was randomly assigned to the leg elevation group ( = 26) or to the control group ( = 26) of usual perioperative care.

RESULTS

The proportions of patients who develop hypotension are lower (8 (33.3%)) in the leg elevation group than the control group (15 (62.5%)) with an (1, = 48) = 4.09, =0.043. The relative risk of developing postspinal hypotension in the leg elevation group compared to the control group was 0.47 (95% CI, 0.28-1.00). The proportion of severe hypotension was significantly decreased in the leg elevation group at a value of 0.02.

CONCLUSION

Performing leg elevation immediately after spinal anesthesia reduced the incidence of hypotension. The trial is registered with PACTR201908713181850.

摘要

背景

脊柱后低血压是剖宫产脊髓麻醉后最常见的并发症。低血压主要是由于血管张力降低导致全身血管阻力下降和静脉回心血量减少。本研究的目的是评估抬高下肢（LE）作为预防脊髓麻醉下剖宫产患者脊柱后低血压方法的有效性。

方法

这是一项单中心平行随机对照试验研究，纳入了52例符合纳入标准、计划择期剖宫产的足月产妇。随机序列由一名不参与患者管理的研究人员使用计算机随机生成器创建。参与者被随机分配到抬高下肢组（n = 26）或常规围手术期护理的对照组（n = 26）。

结果

抬高下肢组发生低血压的患者比例（8例（33.3%））低于对照组（15例（62.5%）），χ²（1，n = 48）= 4.09，P = 0.043。与对照组相比，抬高下肢组发生脊柱后低血压的相对风险为0.47（95%CI，0.28 - 1.00）。在P值为0.02时，抬高下肢组严重低血压的比例显著降低。