Effect of the Position on Hemodynamic Parameters in Elective Cesarean Sections with Spinal Anesthesia: A Retrospective Clinical Trial

Aim: Maternal hypotension after spinal anesthesia is the most common complication. We aimed to compare the haemodynamic effects of patient positions (supine or tilt) applied to avoid spontaneous hypotension in elective cesarean sections performed in our clinic with spinal anesthesia by examining the files of anesthesia records retrospectively. Methods: Data on the 133 elective caesarean sections done in 2017 was examined. Hemodynamic parameters, table position, use of ephedrine, need for additional drugs, and nausea and vomiting were recorded. Surgery started in the supine position in 64 patients (group S), and in the tilt position in 69 (group T). Group T was subdivided into 2 groups: group TS consisted of 29 patients in whom surgery started in the tilt, and continued in the supine position and group TT included 40 patients in whom the surgery was completed in the tilt position. Results: The hemodynamic values in group S were significantly lower than in group T, and a total of 43 patients were administered ephedrine. It was found that in group TT, only four of 40 patients required ephedrine and the total dose was lower than in other groups. Conclusion: We concluded that in elective cesarean sections, maternal hypotension in patients undergoing spinal anesthesia with 15°C tilt position on the left side of the patient is seen less than in patients undergoing in the supine position. In addition, starting with a 15°C tilt position and changing position to the supine position, make a deeper hypotension and increase the dose of ephedrine used.