Summary of findings 6. Lower limb compression versus control.
| Leg compression versus control for preventing hypotension during spinal anaesthesia for caesarean section | ||||||
| Patient or population: women having spinal anaesthesia for caesarean section Setting: hospital setting in Europe, North America, India, and the Middle East Intervention: lower limb compression Comparison: control | ||||||
| Outcomes | Anticipated absolute effects* (95% CI) | Relative effect (95% CI) | № of participants (studies) | Quality of the evidence (GRADE) | Comments | |
| Risk with control | Risk with lower limb compression | |||||
| Maternal hypotension requiring intervention | Study population | RR 0.61 (0.47 to 0.78) | 705 (11 RCTs) | ⊕⊝⊝⊝ Very lowa,b,c | — | |
| 663 per 1000 | 404 per 1000 (312 to 517) | |||||
| Maternal hypertension requiring intervention | No studies reported this outcome. | |||||
| Maternal bradycardia requiring intervention | Study population | RR 0.63 (0.11 to 3.56) | 74 (1 RCTs) |
⊕⊝⊝⊝ Very lowc,d,e | — | |
| 83 per 1000 | 53 per 1000 (9 to 297) | |||||
| Maternal nausea and/or vomiting | Study population | RR 0.42 (0.14 to 1.27) | 276 (4 RCTs) | ⊕⊝⊝⊝ Very lowa,b,c,d | — | |
| 162 per 1000 | 68 per 1000 (23 to 205) | |||||
| Neonatal acidosis as defined by cord or neonatal blood with a pH < 7.2 | No studies reported this outcome. | |||||
| Neonatal Apgar score < 8 at 5 minutes | Study population | Not estimable | 130 (3 RCTs) | ⊕⊝⊝⊝ Very lowa,c,e | No events observed in any studies. Relative effect could not be estimated. | |
| Not pooled | Not pooled | |||||
| Admission to neonatal intensive care unit | No studies reported this outcome. | |||||
| *The risk in the intervention group (and its 95% confidence interval) is based on the assumed risk in the comparison group and the relative effect of the intervention (and its 95% CI). CI: confidence interval; RR: risk ratio. | ||||||
|
GRADE Working Group grades of evidence High quality: we are very confident that the true effect lies close to that of the estimate of the effect. Moderate quality: we are moderately confident in the effect estimate: the true effect is likely to be close to the estimate of the effect, but there is a possibility that it is substantially different. Low quality: our confidence in the effect estimate is limited: the true effect may be substantially different from the estimate of the effect. Very low quality: we have very little confidence in the effect estimate: the true effect is likely to be substantially different from the estimate of effect. | ||||||
aDowngraded one level for serious risk of bias (due to unclear risk of selection bias in the majority of included studies (−1). bSubstantial heterogeneity (−1). cInclusion criteria not representative of wider population (e.g. elective caesarean sections only) (−1). dWide CI that includes potential benefit or no benefit from the intervention (−1). eInadequate sample size (−1).