Abstract
We tested the hypothesis that using a combination of methods would result in a greater reduction in the incidence of hypotension due to spinal anaesthesia in caesarean sections compared with using each method on its own. A total of 120 patients were randomly allocated to the following four treatment groups: 10 mg bupivacaine 0.5% intrathecally plus 500 ml Ringer lactate solution (group B); 4 mg bupivacaine 0.5% plus 25 μg fentanyl plus 500 ml Ringer lactate solution (group F); 4 mg bupivacaine 0.5% plus 25 μg fentanyl intrathecally plus 500 ml Gelofusine® intravenously (group G); and 4 mg bupivacaine 0.5% plus 25 μg fentanyl intrathecally plus 500 ml Gelofusine® intravenously plus tight wrapping of the lower extremities with an Esmarch bandage (group E). The Esmarch bandage was only loosely applied in groups B, F and G. Hypotension was detected in 100% of the patients in group B compared with 70.0%, 46.7% and 23.3% of those in groups F, G and E, respectively. Hypotension was thus reduced by using a combination of several methods.