A Position for Administration of Difficult Spinal Anesthesia

Shabanian, Gholamreza; Saadat, Mitra

doi:10.7860/jcdr/2014/5881.4198

Cited by 2 publications

(3 citation statements)

References 5 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Pendant position decreases the vertical pressure due to gravitation. Hence, this position increases the intervertebral spaces and the spinal needle may reach the subarachnoid space more accurately ( 8 ).…”

Section: Introductionmentioning

confidence: 99%

Comparison Between Pendant Position and Traditional Sitting Position for Successful Spinal Puncture in Spinal Anesthesia for Cesarean Section

2017

View full text Add to dashboard Cite

BackgroundSuccess of spinal anesthesia in pregnant females is strongly influenced by the position of the patient at the time of spinal insertion. Pendant position is a new position introduced to increase the intervertebral spaces. The current study aimed at comparing successful spinal puncture among the patients with pendant position in comparison with the ones with traditional sitting position for the elective caesarean section.MethodsThe current study was a non-blinded, randomized controlled trial (RCT) (registration code: NCT02753660 (ClinicalTrial.gov) on pregnant females undergoing spinal anesthesia. The participants were divided into 2 groups by the random consecutive sampling method; group A (pendant position) and group B (traditional sitting position). The successful placement of spinal needle was determined by the number of attempts, the amount of bone contact, and the time of spinal puncture. The inclusion criteria were pregnant females aged 18 to 45 years, body mass index (BMI) of 18 to 35 kg/m2, and the physical status I to III, based on American society of anesthesiologists classification (ASA).ResultsFollowing the approval of the ethical committee, 308 subjects were enrolled in the study. The rate of successful puncture on the 1st attempt of group A was significantly high (92% vs. 78%, P value = 0.001). Additionally, group A had significantly less total amount of bone contact (185 vs. 421, P value < 0.001) and shorter time for spinal puncture (9 seconds vs. 12 seconds, P value < 0.001).ConclusionsPendant position was significantly better than traditional sitting position to provide successful 1st attempt spinal puncture in pregnant females undergoing cesarean section.

show abstract

Section: Introductionmentioning

confidence: 99%

Comparison Between Pendant Position and Traditional Sitting Position for Successful Spinal Puncture in Spinal Anesthesia for Cesarean Section

2017

View full text Add to dashboard Cite

show abstract

“…Shabanian et al achieved this position by supporting patient's underarms with cantilever or a plank. 10 We used pillows of various sizes that fit adequately between patients under arms and legs, since cantilever was uncomfortable for patients with gravid uterus when tested on few patients from our population before starting study. Pryambodho et al didn't explain in their article about exactly how they made full term patients to sit in pendant position (cantilever or pillows).…”

Section: Discussionmentioning

confidence: 99%

“…5 In pendant position propped underarms reduce vertical pressure (gravity) on the vertebrae, thus increasing intervertebral and inter-spinous distance and interlamina gap. 5,10 A study by Pryambodho et al compared pendant position with TSP in Indonesian population for cesarean section; they concluded that pendant position is much better for achieving spinal puncture in first attempt (p = 0.0007), number of needle-to-bone contact (p = 0.0005) and less time for successful spinal (9 sec vs. 12 sec, p = 0.001). 8 Fisher et al claimed that number of needle-to-bone contacts was equal in both positions during epidural labor analgesia.…”

Section: Introductionmentioning

confidence: 99%

Comparison of successful spinal puncture between pendant position and traditional sitting position for cesarean deliveries

Arshad¹,

Jadoon²,

Raza³

et al. 2020

APIC

View full text Add to dashboard Cite

Background & objectives: Several positions are used for performing subarachnoid block with varying difficulty of spinal access. Pendant position is known to reduce lumbar lordosis in patients’ especially pregnant patients making spinal access easier. The most ideal position for the easy spinal access is yet to be determined. This study was planned to compare ease of spinal access in pendant position vs. traditional sitting position (TSP) in pregnant females, and to establish the superiority of the former. Methodology: This randomized controlled trial was conducted in our hospital on 232 subjects over 6 month period. Parturients undergoing elective lower segment cesarean section (LSCS) were randomly divided into two groups: Group A (pendant group) and Group B (TSP group). Spinal puncture was performed at L3-L4 interspace, randomly making one of the two positions. Time for successful spinal, number of needle-to-bone contacts and total number of attempts were recorded. Results: The median age of the patients was 29 yrs with the interquartile range (IQR) 7. The number of needle-to-bone contacts in Group A was significantly higher compared to Group B (59.48% vs. 33.62%, p = 0.000). Mean time for successful spinal puncture was less in Group A than Group B (17.69 sec vs. 25.54 sec, p = 0.001). The difference in number of attempts for spinal in both positions was not significant. Conclusion: Pendant position is better than traditional sitting position in achieving successful spinal puncture in terms of needle-to-bone contacts and the time to puncture. However there is no difference in number of attempts for both positions. Key words: Traditional sitting position; Pendant position; Spinal anesthesia; Cesarean section Citation: Arshad QUA, Jadoon H, Raza A, Furqan Z, Shahani YA. Comparison of successful spinal puncture between pendant position and traditional sitting position for cesarean deliveries. Anaesth. pain intensive care 2020;24(6):--- Received: 13 July 2020, Reviewed: 28 September 2020, Accepted: 29 September 2020

show abstract

A Position for Administration of Difficult Spinal Anesthesia

Cited by 2 publications

References 5 publications

Comparison Between Pendant Position and Traditional Sitting Position for Successful Spinal Puncture in Spinal Anesthesia for Cesarean Section

Comparison Between Pendant Position and Traditional Sitting Position for Successful Spinal Puncture in Spinal Anesthesia for Cesarean Section

Comparison of successful spinal puncture between pendant position and traditional sitting position for cesarean deliveries

Contact Info

Product

Resources

About