Effect of Application of Lower Limb Venous Compression on Maternal Blood Pressure during Caesarean Section under Spinal Anaesthesia

Background: Maternal hypotension from spinal anaesthesia poses significant risks warranting continued search for effective prophylaxis.

Aim: The study aims to compare the effects of knee high (KH) and thigh high (TH) sequential compression stockings (SCS) on maternal blood pressure during Caesarean section under spinal anaesthesia.

Methods: Following Ethical approval, 150 consenting eligible parturients aged 18 – 45 years, of American Society of Anesthesiologists class I and II, scheduled for elective Caesarean, were randomized into KH, TH, and control (CT) groups, of 50 each. While groups KH and TH wore knee- high and thigh-high SCS respectively, including sham stockings, group CT wore sham stockings only. Following inflation of the SCS to 30-40 mmHg bilaterally, and 15 ml/kg 0.9% normal saline pre-loading, parturients received 2ml of hyperbaric bupivacaine 0.5% plus 25µg fentanyl, intrathecally, via L3/L4 intervertebral space in sitting position; post block heart rate, blood pressures were recorded. Hypotension was defined as > 20% decrease in baseline, or a systolic blood pressure < 90 mmHg.

Results: All 150 parturients completed the study. Hypotension occurred greatest [44 (37.9%)] in group CT, followed by group KH [40 (34.5%)] and least [32 (27.6%)] in group TH, p < 0.001, with significantly greatest ephedrine consumption in group CT, p = 0.008.

Conclusion: Knee-High and Thigh-High SCS application significantly reduced the incidence of maternal hypotension during Caesarean section under spinal anaesthesia, with superiority of the TH over the KH, and minimal side effects.