SITTING VERSUS LATERAL POSITION FOR INDUCTION OF SPINAL ANESTHESIA IN ELDERLY PATIENTS â€“ A RANDOMIZED CONTROLLED TRIAL

Showkat Ahmad Bhat; Showkat Hussain Tali; Kumar Nm; Shagufta Yousuf

doi:10.22159/ajpcr.2017.v10i2.15523

Authors

Showkat Ahmad Bhat
Showkat Hussain Tali Health services kashmir
Kumar Nm
Shagufta Yousuf

DOI:

https://doi.org/10.22159/ajpcr.2017.v10i2.15523

Abstract

Objectives: To compare the effect of induction position (sitting versus lateral) for spinal anaesthesia in the elderly patient on hemodynamic, sensory block and motor block characteristics and patient satisfaction.

Material and methods: Randomized controlled trial of patients undergoing spinal anaesthesia for lower abdominal, pelvic, lower limb and urological surgeries aged more than 60 years. Hyperbaric Bupivacain (0.05%) was injected into the spinal space while the patients were either in sitting or lateral position. Effects on hemodynamic parameters, sensory block and motor block characteristics and patient satisfaction were analysed.

Results: Induction position for spinal anaesthesia does not affect the hemodynamic parameters and incidence of adverse effects when adequate preloading is done. There was no statistically significant difference in the sensory level and motor level achieved. However lateral position appears to be more comfortable for elderly patients (P= 0.03).

Conclusions: Induction position for administration of spinal anaesthesia has no effect on hemodynamic parameters or block characteristics except that patients feel more comfortable in lateral position.

Keywords: Spinal anesthesia, Induction position, Hyperbaric bupivacaine.

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References

Fredman B, Zohar E, Rislick U, Sheffer O, Jedeikin R. Intrathecal anaesthesia for the elderly patient: The influence of the induction position on perioperative haemodynamic stability and patient comfort. Anaesth Intensive Care 2001;29(4):377-82.

Kelly JD, McCoy D, Rosenbaum SH, Brull SJ. Haemodynamic changes induced by hyperbaric bupivacaine during lateral decubitus or supine spinal anaesthesia. Eur J Anaesthesiol 2005;22(9):717-22.

Birnbach DJ, Browne IM. Anesthesia for obstetrics. In: Miller RD, editor. Anesthesia. 7th ed. USA: Churchill Livingstone, An Imprint of Elsevier; 2009. p. 2203-40.

Kalso E, Tuominen M, Rosenberg PH. Effect of posture and some c.s.f. characteristics on spinal anaesthesia with isobaric 0.5% bupivacaine. Br J Anaesth 1982;54(11):1179-84.

Kuusniemi KS, PihlajamÃ¤ki KK, PitkÃ¤nen MT, Helenius HY, KirvelÃ¤ OA. The use of bupivacaine and fentanyl for spinal anesthesia for urologic surgery. Anesth Analg 2000;91(6):1452-6.

Shahzad K, Afshan G. Induction position for spinal anaesthesia: Sitting versus lateral position. J Pak Med Assoc 2013;63(1):11-5.

Obasuyi BI, Fyneface-Ogan S, Mato CN. A comparison of the haemodynamic effects of lateral and sitting positions during induction of spinal anaesthesia for caesarean section. Int J Obstet Anesth 2013;22(2):124-8.

Arokyamuthu V, Joseph EJ. A comparison of hemodynamic effects of lateral and sitting positions during induction of spinal anaesthesia for caesarean section. Global journal for research analysis 2016;5(4).

Laithangbam PK, Singh NR, Fanai RL, Singh SS, Shashank DS, Nayagam HA. Comparision of lateral, Oxford and sitting positions for combined spinal and epidural ansthesia for elective caesarean section. Journal of Medical Society 2013; 27(1): 70-4. DOI: 10.4103/0972- 4958.116651.