DR.AARTHI. C,DR. GIRIMURUGAN,DR. RAJASEKARAN KV
DOI: https://doi.org/Background: Postspinal hypotension (PSH) remains one of the most common and significant complications during cesarean delivery under spinal anesthesia, affecting up to 80% of parturients. It can lead to maternal nausea, vomiting, dizziness, and, in severe cases, compromised uteroplacental perfusion and fetal distress . Although vasopressors remain the pharmacological mainstay for PSH prevention, their use may be associated with undesirable maternal and fetal effects. Non-pharmacological strategies, such as lower limb compression, have been proposed to improve venous return and maintain preload. This study evaluated the effect of leg wrapping using elastic bandages in reducing the incidence and severity of PSH during elective cesarean sections under spinal anesthesia .Methods: In this prospective randomized controlled trial, 60 healthy pregnant women (ASA II, aged 18–35 years) scheduled for elective cesarean delivery under spinal anesthesia were randomized into two groups: Intervention Group (n=30), who received leg wrapping from ankles to mid-thigh immediately after induction of spinal anesthesia, and Control Group (n=30), who did not receive leg wrapping. All patients received standardized spinal anesthesia with 0.5% hyperbaric bupivacaine, preloading with crystalloid, and standard intraoperative monitoring. Primary outcomes were the incidence of PSH and mean arterial pressure (MAP). Secondary outcomes included vasopressor requirement, incidence of nausea/vomiting, shivering, and neonatal Apgar scores. Data were analyzed using Student’s t-test and Chi-square test. Results: The incidence of PSH was significantly lower in the Intervention Group (30%) compared to the Control Group (70%) (p<0.001). Mean MAP was higher in the Intervention Group (81±5 mmHg) than in the Control Group (72±7 mmHg) (p<0.001). Vasopressor use was reduced (33% vs 67%, p=0.01), and the incidence of nausea was lower (20% vs 50%, p=0.03) in the Intervention Group. Neonatal outcomes, as assessed by Apgar scores, were comparable between groups (p>0.05).Conclusion: Leg wrapping is a simple, inexpensive, and effective non-pharmacological method to reduce the incidence and severity of PSH in parturients undergoing cesarean delivery under spinal anesthesia. By enhancing venous return and improving hemodynamic stability, leg wrapping may serve as a valuable adjunct to current preventive strategies.
