Razi Journal of Medical Sciences

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ABSTRACT The effect of position on the spread and the onset time of epidural anesthesia has not been well documented. This study is undertaken to assess the effect of modified trendelenburg position on the spread of epidural anesthesia for cesarean section. 739 parturients were undergone epidural anesthesia for elective or emergent sesarean section. They were divided into 2 groups in a randomized controlled study. All patients received a standard epidural anesthesia. The first group was placed in 15-degree trendelenburg with 10-degree head-up position and the second in horizontal position. The onset time and the level of anesthesia, patients hemodynamics, and neonate’s apgar score were recorded in both groups. Hemodynamics, arterial oxygen saturation, and apgar scores had not significant differences in positioned and non-positioned groups. The results show significant differences in the time of onset (in average 4 minutes faster in modified-Trendelenburg-positioned group)(P<0.001), and in achieving T5 level sensory blockade (97.5% versus 42.8%) between positioned and non-positioned pregnant women. This study demonstrates that modified trendelenburg position has a significant effect on the spread and the onset time of epidural anesthesia, and can be used safely in term parturients who are candidate for emergency or elective cesarean section.

Keywords: 1) Lidocain 2) Cesarean section 3) Trendelenburg position 4) Epidural ansthesia

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