Effect of thromboembolic deterrent stockings at spinal anesthesia-induced hypotension

Kim, Won Sung; Baik, Seong Wan; Kim, Hye Jin; Yoon, Ji Young; Lee, Hyeon Jeong; Kim, Tae Kyun

Abstract

BACKGROUND: Hypotension during spinal anesthesia is mainly result of sympathetic blockade, which causes pooling of blood into the lower extremities. Mechanical compression of lower limbs prevents venous pooling of blood. Thromboembolic deterrent (TED) stockings are in general surgical use for prophylaxis against lower limb deep vein thrombosis and TED stockings also supply pressure to lower limb. So we investigated the effect of TED stockings to prevent hypotension during spinal anesthesia.
METHODS
Sixty patients were randomized to receive fluid loading (crystalloid, 10 ml/kg) or TED stockings. After spinal anesthesia (heavy bupivacaine 14 mg), patients were placed in supine position for 12 minutes and in lithotomy position for 18 minutes. Blood pressure, pulse rates, shivering, and nausea were checked every 3 minutes for 30 minutes. If the systolic blood pressure was less than 90 mmHg or mean blood pressure was less than 80% of baseline mean blood pressure then i.v. ephedrine 5 mg was administered.
RESULTS
There was no statistically significant difference in baseline characteristics and blocked sensory level between the two groups. There was no statistically significant difference in the incidence of hypotension and mean arterial blood pressure at each time.
CONCLUSIONS
We conclude that, under the conditions of this study, TED stockings decrease the pooling of blood into the lower limbs and prevent hypotension after spinal anesthesia. Although TED stockings prevent hypotension after spinal anesthesia, it does not reduce the incidence of hypotension.