Completed

NCT Number: NCT07534891

The Effect of Compression Stockings and Leg Elevation on Hemodynamic Stability in Elective Cesarean Sections Under Spinal Anesthesia: A Single-Blind Randomized Controlled Trial

Aim:

This study aimed to evaluate the effects of compression stockings and leg elevation on maternal intraoperative hypotension, vasopressor requirement, and neonatal well-being parameters in women undergoing elective cesarean section spinal anesthesia.

Methods:

This single-blind randomized controlled experimental study was conducted in the obstetrics service and operating room of Afşin State Hospital between November 1, 2023, and February 20, 2025. A total of 90 pregnant women who met the inclusion criteria were randomly assigned into three groups: the compression stockings group (n=30), the leg elevation group (n=30), and the control group (n=30). Spinal anesthesia was administered to all participants according to a standardized protocol. Maternal systolic, diastolic, and mean arterial blood pressure, as well as heart rate, were monitored at regular intervals during the intraoperative period. The occurrence of hypotension, vasopressor use, and side effects such as nausea and vomiting were recorded. Neonatal outcomes included the 5-minute APGAR score and umbilical venous blood gas parameters (pH and base excess). Data were analyzed using appropriate statistical methods.

Results:

Intraoperative systolic, diastolic, and mean arterial blood pressure values were significantly higher in both the compression stockings and leg elevation groups compared to the control group (p<0.05). The rate of vasopressor use was significantly lower in both intervention groups compared to the control group (p<0.05). There were no statistically significant differences among the groups in terms of neonatal APGAR scores, umbilical venous pH, and base excess values (p>0.05).

Conclusion:

The use of compression stockings and leg elevation in women undergoing elective cesarean section تحت spinal anesthesia are effective, safe, and feasible non-pharmacological methods for maintaining maternal hemodynamic stability. These interventions reduce vasopressor requirements and hypotension-related side effects without adversely affecting short-term neonatal outcomes. The findings suggest that these methods can be integrated into clinical nursing practice for the prevention of spinal anesthesia-induced hypotension.

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Key information

Conditions

Maternal Hypotension Associated With Spinal Anesthesia During Cesarean Section

Age range

18 year–40 year

Sex eligibility

Female

Study type

Interventional

Phase

Not applicable

Primary location

Kahramanmaraş Afşin Devlet Hastanesi

Kahramanmaraş, 46500, Turkey (Türkiye)

Who can participate

Healthy volunteers accepted: No

Only the study team can determine whether someone qualifies for participation.

Inclusion criteria

Gestational age between 37-40 weeks, Planned elective cesarean section, Maternal age between 19-40 years, Singleton pregnancy, Planned spinal anesthesia, Estimated fetal weight between 2500-4000 g.

Exclusion criteria

Known hypertensive disorders, History of severe lower extremity injury, History of deep vein thrombosis, Use of anticoagulant therapy, Placental invasion or placental localization abnormalities with a high risk of bleeding, Requirement for general anesthesia, Known fetal anomalies, Signs of acute or chronic fetal distress, Development of maternal complications during the operation.

Treatment and study plan

compression stockings

Device

a medical device that applies graduated pressure to the lower extremities to enhance venous return

leg elevation

Other

a positional intervention involving elevation of the lower extremities above the level of the heart to enhance venous return"

Primary outcomes

Maternal intraoperative hypotension

Time frame: throughout the cesarean section

Maternal hypotension during spinal anesthesia
Maternal intraoperatif hipotansiyon

Time frame: throughout the cesarean section

Maternal intraoperatif hipotansiyon

Sponsors and collaborators

Lead sponsor

Seçil Yavaş