Comparison of Leg-Wrapping with and without Glycopyrrolate Administration for Prevention of Hypotension after Spinal Anesthesia in Cesarean Section Patients: a Randomized Controlled Trial

Abstract

Background: Hypotension is a common side effect to occur after spinal anesthesia in pregnant women, which leads to severe complications. In previous studies, the leg wrapping method was employed to reduce the incidence of hypotension after spinal anesthesia, including the glycopyrrolate administration before spinal anesthesia. This study aims to indicate and compare the efficiency between solely leg wrapping and leg-wrapping with glycopyrrolate administration, in terms of a prevention of hypotension after spinal anesthesia in cesarean section, which could lead to a useful preventive technique in the practice. Methods: This prospective randomized controlled trial was conducted at Vajira Hospital from April 2022 to July 2023. Patient undergoing cesarean section were randomized into 2 groups: group A received leg wrapping, group B received leg wrapping with administration of glycopyrrolate 0.2 mg. Primary outcome variable is the incidence of hypotension. Secondary outcomes are the incidence of bradycardia, vasopressor used, nausea and vomiting and neonatal APGAR score. Results: This study enrolled 164 patients, 82 patients per group. The incidence of hypotension within 30 min after spinal anesthesia was not statistically significant between the two groups. Although the median dose of ephedrine in both groups was equal, however, a median dose of norepinephrine in group A was significantly lower than in group B (P=0.038). Conclusion: The incidence of hypotension within 30 min after spinal anesthesia in cesarean section patients between leg wrapping with and without the administration of glycopyrrolate was not significantly different. These prevention techniques should be employed to reduce hypotension after spinal anesthesia.