Comparison of Hemodynamic Effects and Patient Satisfaction Between Lateral Versus Sitting Maternal Positions for Cesarean Deliveries in Spinal Anesthesia

Objective: To compare the hemodynamic effects of spinal anesthesia in sitting vs. lateral maternal positions in terms of patient comfort and anesthetist convenience. Study Design: Quasi-experimental study. Place and Duration of Study: Department of Anesthesia, Combined Military Hospital, Lahore Pakistan, from Jun 2018 to Dec 2018. Methodology: Two hundred and sixteen patients admitted for Cesarean deliveries were randomly selected and divided into two groups of 108 each for spinal anesthesia in sitting (S-Group) or lateral (L-Group) positions. Baseline heart rate and blood pressure were recorded and readings for both were measured after every two minutes for 15 minutes. Hypotension and bradycardia were noted and treated. Patients were interviewed afterwards for comfort in sitting or lateral position and the number of spinal anesthesia attempts made were also recorded. Results: In L-Group, 36(33%) patients had hypotension while 60(55.5%) had hypotension in S-Group. In L-Group, 4(3.7%) patients and 8(7.4%) patients in S-Group had bradycardia. Six patients (5.5%) in the Lateral-Group and 13(12%) in Sitting-Group required therapy for which the p-value came out to be significant. In Lateral-Group, 98 patients (90.7%) were comfortable and 9(8.3%) were uncomfortable, 1(0.97%) was agitated whereas in Sitting-Group 78(72%) were comfortable, 25(23%) were uncomfortable and 5(5%) were agitated. Subarachnoid puncture was 87% successful in S-Group and 74% successful in L-Group in 1st attempt. Conclusion: Lateral spinal position was more comfortable with better hemodynamics however sub arachnoid puncture was easier in sitting position.