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

Abstract

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

Comparison between Pendant Positions versus Traditional Sitting Positions for Successful Spinal Puncture in Patients Undergoing Caesarean Deliveries

“…These results were comparable to the previous studies. 18,19 A number of encounters between the needles and the bones have been linked to anxiety and fear that affect the patient's bleeding, e.g. tachycardia and sometimes hypertension.…”

“…However, the present study has identified a success for spinal anaesthesia when a spinals needle has been established in the subarachnoid area as well as a good blood free and clear CSF outflow from the spinal needle. 19…”