Lateral table tilt or a pelvic wedge are commonly used to reduce inferior vena cava compression during obstetric anaesthesia in the supine position. Direct measurement of pelvic angle allows individual assessment of the effectiveness of these manoeuvres in achieving a tilted position. We observed routine practice during caesarean section after random allocation to one or other of these methods. The anaesthetist managing the case was asked to position the women after induction of spinal anaesthesia using either left table tilt or a wedge under the right hip. We then measured pelvic angle in all women, and the table angle in women who had table tilt. The mean (SD [range]) pelvic angle was 20.2° (8.1° [9°-37°]) in 18 women with table tilt and 21.0° (7.5° [10°-36°]) in 17 women with a wedge. The mean (SD [range]) table angle was 12.4° (3.1° [8°-21°]) in the women with table tilt. There was a significant difference between table angle and pelvic angle in the women with table tilt (p = 0.0003), but no significant difference in pelvic angle between the table tilt and wedge groups. Measurement of table angle does not represent pelvic position adequately in the majority of women. However, this study showed that lateral table tilt and a pelvic wedge were equally effective in producing tilt of the pelvis.

译文

侧卧台倾斜或骨盆楔形通常用于减轻仰卧位产科麻醉期间的下腔静脉压迫。直接测量骨盆角度可以单独评估这些动作在实现倾斜位置方面的有效性。在随机分配给这些方法中的一种或另一种后,我们观察了剖腹产期间的常规做法。要求处理该病例的麻醉师在使用左表倾斜或右臀部下方的楔形物诱导脊柱麻醉后对妇女进行定位。然后,我们测量了所有女性的骨盆角度,以及有桌子倾斜的女性的桌子角度。18位倾斜的女性平均 (SD [范围]) 骨盆角度为20.2 ° (8.1 ° [9 °-37 °]),17位楔形女性为21.0 ° (7.5 ° [10 °-36 °])。在倾斜桌子的妇女中,平均 (SD [范围]) 桌子角度为12.4 ° (3.1 ° [8 °-21 °])。台倾斜妇女的台角和骨盆角度有显著性差异 (p   =   0.0003),但台倾斜组和楔形组的骨盆角度无显著性差异。在大多数女性中,测量桌子角度并不能充分代表骨盆位置。然而,这项研究表明,侧面倾斜和骨盆楔形在产生骨盆倾斜方面同样有效。

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