Key result
The use of a sequential compression device significantly reduced the incidence of hypotension compared to crystalloid preloading (32.5% vs 55.0%, OR 0.39, p=0.043) during elective caesarean section.
Why the study?
Spinal anesthesia-associated hypotension has a high incidence in obstetric anesthesia, requiring stable hemodynamics to reduce morbidity and enhance maternal safety.
Does a sequential compression device prevent hypotension associated with spinal anesthesia in patients undergoing elective caesarean section compared to standard crystalloid preloading?
RCT (n=80)
Open-label
Computer generated random table
No
Does a sequential compression device prevent hypotension associated with spinal anesthesia in patients undergoing elective caesarean section compared to standard crystalloid preloading?
Odds Ratio: 0.39 (95% CI 0.16–0.98)
Absolute Event Rate: 32.5% vs 55%
p-value: p=0.043
A sequential compression device is more effective than standard crystalloid preloading for preventing hypotension in pregnant women undergoing elective caesarean section under spinal anesthesia.
SCD reduces spinal hypotension incidence versus crystalloid preload in elective cesarean; extends non-pharmacologic prevention options in obstetric anesthesia.
A very high incidence of hypotension associated with spinal anesthesia (SA) is a matter of concern in obstetric anesthesia and a stable hemodynamic status is required to reduce morbidity furthermore to improve maternal safety. In this study we aim to evaluate the efficacy of sequential compression device for prevention of spinal anesthesia induced hypotension as compared to the standard crystalloid preloading. In this prospective randomized study, total 80 patients with ASA grade I/II divided were enrolled after ethical approval. The patients were randomly allocated into two groups (40 patients in each group) using the computer generated random table. Mechanical Pump (Group M): Sequential compression device was applied and discontinuous compression was started at 60 mmHg and Crystalloid group (Group C) - Patients were preloaded with Ringer’s lactate (RL) at dose of 10 ml/kg for not more than 10 minutes. Spinal block was given and RL was started at rate of 10-15 drops/min to keep venous line patent. The Chi Square test and Unpaired Student’s‘t’ tests were used. Statistically significant differences were observed in heart rate, systolic BP, diastolic BP, mean arterial pressure. The percentage drop in systolic BP from baseline was significantly more in crystalloid group (p=0.043). The sequential compression device is useful for prevention of hypotension in pregnant females undergoing elective caesarean section under spinal anesthesia.
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Singh et al. (2022) conducted an RCT in Hypotension associated with spinal anesthesia (n=80). Sequential compression device vs. Crystalloid preloading (Ringer's lactate 10 ml/kg) was evaluated on Incidence of hypotension (SBP drop by >20% of baseline or <90mmHg) (OR 0.39, 95% CI 0.16-0.98, p=0.043). The use of a sequential compression device significantly reduced the incidence of hypotension compared to crystalloid preloading (32.5% vs 55.0%, OR 0.39, p=0.043) during elective caesarean section.
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