The Effect of Spinal Anesthesia that is Performed in Sitting or Right Lateral Position on Post-Spinal Headache and Intraocular Pressure During Elective Cesarean Section

Abstract

Background: Although spinal anesthesia can be applied in different patient positions, the most frequently used positions are sitting and lateral positions.  It is known that different patient positions during spinal anesthesia have effects on hemodynamic parameters, postdural puncture headache,  and intraocular pressure.

Aim: The study aimed to determine the effect of spinal anesthesia performed in either sitting or right lateral position on postspinal headache and  intraocular pressure during elective cesarean section. Patients and Methods: The study was a randomized controlled study of 104 eligible pregnant  women scheduled to undergo elective cesarean section. The women were randomized into two groups. Spinal anesthesia was performed either in the  sitting (Group S, n = 53) or the right lateral position (Group L, n = 51). Heart rate and blood pressure were recorded throughout the operation. The  participants were informed and monitored for postspinal headaches. Intraocular pressure before and after the operation was measured with Icare PRO.  The obtained data were statistically compared between the two groups.

Results: There was no difference between the groups in terms of demographic data. Postdural puncture headache was observed in five patients in Group S and one patient in Group L (P =0.04). There was no difference between the  groups in terms of intraocular pressure (P >.05). Heart rate was not significantly different between the groups; however, there was a significant difference  in average blood pressure in 1, 5, 30, and 40 minutes (P <.05). The number of trials administered to patients for spinal anesthesia was significantly higher  in Group L (P =0.01).

Conclusion: Spinal anesthesia performed in the sitting position for cesarean section caused a higher postspinal headache than in  the right lateral position, but the position did not affect intraocular pressure.