Comparative Study of Isobaric Bupivacaine Spinal Anesthesia in the Supine and Prone Positions

Chang, Chul Ho; Nam, Yoonho; Jeong, Joo Young; Choi, Sehee; Lee, Youn Woo

doi:10.4097/kjae.2003.44.5.605

Cited by 4 publications

(2 citation statements)

References 18 publications

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“…The patient’s position may be critical in determining the final levels of motor and sensory blocks. Chang et al previously studied the effect of spinal anesthesia in supine and prone position surgeries with isobaric bupivacaine and found no difference in sensory and motor block levels [ 15 ]. Toptaş et al studied the effects of hyperbaric and isobaric bupivacaine on the spinal block.…”

Section: Discussionmentioning

confidence: 99%

Investigating the Effect of the 10° Reverse Trendelenburg Position on Spinal Block Characteristics and Hemodynamic Parameters in Lower Limb Surgeries

Rajwal¹,

Bhandari²,

Thakur³

et al. 2022

Cureus

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Introduction: The primary goal of spinal anesthesia in lower limb surgeries is to achieve a successful sensory and motor block. Adequate level of spinal block for lower limb orthopedic surgery is T10. Due to multiple factors affecting the level of spinal anesthesia, it is not always easy to control the level of spinal anesthesia.We proposed that maintaining patients in a 10° reverse Trendelenburg position after spinal anesthesia can significantly control the height of the sensory block, resulting in stable hemodynamics. Materials and methods: This study is a single centric, prospective, single-blinded randomized clinical trial (CTRI/2018/08/015455) conducted in a tertiary care center in Sub-Himalayan region in India from July 2018 to June 2019. Total 60 patients fulfilling our inclusion and exclusion criteria were recruited in the study and were divided into two groups. In the supine group, patients were positioned in the supine position, and in the Trendelenburg group, patients were positioned in a 10° reverse Trendelenburg position after administering spinal anesthesia with 12.5 mg bupivacaine heavy. The two groups were compared in terms of sensory block, motor block, and analgesia duration. Heart rate, blood pressure, mean arterial pressure, and hypotension were also compared between the two groups. Results: Duration of sensory block, motor block, and analgesia were significantly higher in patients of the reverse Trendelenburg group (group T) compared to the supine group (group S). In group T, 26.6% had a sensory block level above T8, whereas in group S, 86.6% of patients had a sensory block level above T8. No hypotension was observed in the Trendelenburg group, which was present in 33% of patients in the supine group (group S). Conclusion: Ten-degree reverse Trendelenburg position immediately after giving spinal anesthesia significantly limits the level of sensory block and provides better hemodynamic stability, and can be more beneficial, especially in geriatric patients and other high-risk patients for lower limb surgeries.

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Section: Discussionmentioning

confidence: 99%

Investigating the Effect of the 10° Reverse Trendelenburg Position on Spinal Block Characteristics and Hemodynamic Parameters in Lower Limb Surgeries

Rajwal¹,

Bhandari²,

Thakur³

et al. 2022

Cureus

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show abstract

“…Chang et al also compared the spinal anesthesia for supine and prone position surgeries using isobaric bupivacaine, there was no significant difference in sensory & motor block level [5]. Our study was having higher patient sample and we used hyperbaric bupivacaine.…”

Section: Discussionmentioning

confidence: 67%

Standard Spinal Anaesthesia Then Turned Prone for Lower Limb Orthopaedic Surgeries

Shaikh¹,

Alkhayarin²,

Vegesna³

et al. 2018

Int J Anesth Pain Med

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Spinal anesthesia compared to the general anesthesia has advantages of decrease blood loss, better cardiovascular stability and post-operative pain control. Spinal anesthesia for lower limb orthopedic surgeries in prone position is not well described in the literature. The aim of this study was to know the safety and feasibility of spinal anesthesia for lower limb orthopedic surgeries in prone position.Patients and Methods: Patients undergoing lower limb orthopedic surgeries in prone position under spinal anesthesia in a tertiary health care facility over a period of 10 years were included in this study. Patient demographic data, surgical procedure, ASA grade, position for spinal anesthesia, local anesthetic with or without opioids, level of sensory block and complication if any were recorded retrospectively.Results: A total 104 patients were included in our study. The Majority of our patients were male. Fifty two percent had fracture calcaneus surgery. Average height of spinal block was thoracic 9 vertebra. Patients turned to prone position after 8.59 ± 3.6 minutes. Eighty seven percent patients received fentanyl with heavy bupivacaine. The most frequent complication was hypotension (18.3%). There were significant difference between occurrence of complication and patients age, gender, BMI, ASA grading and comorbid condition. No major complications occurred which needed to turn the patient back in to supine after prone positioning. Conclusion:Spinal anesthesia in prone position is safe and feasible for lower limb orthopedic surgeries. Our study showed that complications of lower limb orthopedic surgeries in prone position under spinal anesthesia were negligible.

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Spinal anaesthesia versus general anaesthesia using laryngeal mask airway for anorectal surgeries in prone position: A controlled clinical trial

Almustafa

Qudaisat

Abbad

et al. 2020

Perioperative Care and Operating Room Management

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Comparative Study of Isobaric Bupivacaine Spinal Anesthesia in the Supine and Prone Positions

Cited by 4 publications

References 18 publications

Investigating the Effect of the 10° Reverse Trendelenburg Position on Spinal Block Characteristics and Hemodynamic Parameters in Lower Limb Surgeries

Investigating the Effect of the 10° Reverse Trendelenburg Position on Spinal Block Characteristics and Hemodynamic Parameters in Lower Limb Surgeries

Standard Spinal Anaesthesia Then Turned Prone for Lower Limb Orthopaedic Surgeries

Spinal anaesthesia versus general anaesthesia using laryngeal mask airway for anorectal surgeries in prone position: A controlled clinical trial

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