Comparison of Classic and Sequential Spinal Techniques for Preventing Hypotension During Cesarean Delivery.

Incidence of Post-Spinal Anaesthesia Hypotension in Caesarean Delivery: A Randomized Trial of Classic Versus Sequential Spinal Technique

Given the clinical importance of maternal hypotension, the potential advantages of sequential spinal dosing warrant formal evaluation in a prospective, adequately powered randomized controlled trial. We therefore designed this study to compare the incidence of post-spinal hypotension between the classic single-shot spinal and the sequential fractionated spinal techniques in elective cesarean delivery.

Inclusion Criteria:

• Adult women aged 18-45 years.
• ASA physical status II-III.
• Scheduled for elective cesarean section under standardized spinal anesthesia.

Exclusion Criteria:

• Allergy to local anesthetics.
• Emergency cesarean section.
• Contraindication to spinal anesthesia (e.g., coagulopathy, infection at the puncture site).
• Preexisting hypertension on medication or pre-eclampsia with severe features.
• Known cardiac disease accompanied by hemodynamic instability.
• Allergy to study drugs.
• Fetal distress or non-reassuring cardiotocography (CTG).
• BMI >40 kg/m².
• Refusal to sign informed consent.