Comparing the Effects of Sitting Duration and Lateral Positioning on Hemodynamics and Neonatal Outcomes During Spinal Anaesthesia for Elective Caesarean Section.

BACKGROUND: Spinal anaesthesia is widely used for caesarean sections. However, patient positioning during its administration can influence hemodynamic outcomes. This study compares the effects of different sitting durations and lateral positioning on hemodynamics and neonatal outcomes following spinal anaesthesia for elective caesarean section. METHODS: A total of 135 pregnant women scheduled for elective caesarean section under spinal anaesthesia were randomly divided into three groups of 45 each: Group S1 - Sitting for one minute, Group S2 - Sitting for two minutes, and Group L - Lateral position. Haemodynamic variables (heart rate, mean arterial pressure (MAP) and oxygen saturation (SpO2)), requirements for vasopressors, sensory and motor block levels, APGAR scores, patient satisfaction, and complications were recorded. RESULTS: After 10 minutes of spinal anaesthesia, MAP decreased significantly in Groups S1 and S2 compared to Group L (p < 0.05). Patients in Group L maintained better haemodynamic stability throughout the surgery. Sensory and motor block levels were comparable among all groups. The mean time to achieve the highest sensory block level was 4.20 ± 1.31 minutes in Group L, 6.73 ± 1.03 minutes in Group S1, and 6.82 ± 1.05 minutes in Group S2 (p < 0.05). Vasopressor requirement was significantly lower in Group L (6.43 ± 1.60 mg) compared to Groups S1 and S2 (14.25 ± 5.71 mg and 13.03 ± 5.57 mg, respectively) (p < 0.05). APGAR scores at one minute and five minutes were higher in Group L compared to Groups S1 and S2 (p < 0.05). Patient satisfaction scores were also significantly higher in Group L, with fewer complications compared to Groups S1 and S2. CONCLUSION: The lateral position provided superior haemodynamic stability, higher patient satisfaction, and better neonatal outcomes compared to sitting positions during spinal anaesthesia for elective caesarean section.