Abstract
Background: Several methods have been used to prevent
post spinal hypotension including preloading, co-loading,
use of vasopressors, placement of pelvic wedge, lumbar
wedge and tilting of operating table in parturients undergoing
cesarean section. We conducted a randomized controlled
study to determine the hemodynamic effects of a standard
pelvic wedge placed below the right hip immediately after
the spinal block till the delivery of baby.
Methods: One hundred consenting women undergoing
elective cesarean section under spinal anesthesia were
randomly allocated to wedge group (N=50) and control
group (N=50). A standard wedge was placed under the
right pelvis soon after spinal anesthesia till the delivery of
baby in wedge group whereas the control group remained
supine. Hemodynamic parameters including blood pressure,
heart rate, vasopressor consumption, other side effects like
nausea, vomiting and neonatal outcome were also recorded.
Results: The incidence of hypotension and bradycardia
was similar between groups (Wedge group 60% vs Control
group 75.51%, p=0.125) before the birth of baby. The use of
vasopressors (p=0.212), incidence of nausea (p=0.346) and
Apgar score at 1 and 5 minutes (p=0.629, p=0.442) were
also not statistically significant. None of the patients had
vomiting.
Conclusion: In our study, the use of right pelvic wedge
immediately after spinal anesthesia was not effective in
preventing post spinal hypotension in elective cesarean
section.
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