Original Articles
Comparative study of sitting versus lateral position for induction of spinal anesthesia in elderly patients | |
Dr. Vrinda Sarkar, Dr. Pradyumna Singh Kakodia, Dr. Chris Leslie Lemos, Dr. Chhavi Dwivedi, Dr. Meena Singh, Dr. Aparna Tamaskar, Dr. Amit Jain | |
Introduction: Spinal anesthesia is one of the most common methods of sensory and motor blockade used worldwide, to provide regional anesthesia. It is mainly used for surgeries involving the lower limbs and the abdominal region below the level of the umbilicus.It involves injecting a drug, usually a local anesthetic agent into the subarachnoid space. The subarachnoid space contains the cerebrospinal fluid (CSF) which bathes the spinal roots and the spinal cord completely. The number of elderly patients presenting for surgery has increased exponentially in recent years and spinal anaesthesia appears to be more beneficial in these patients for infraumbilical surgeries. Spinal anaesthesia can be initiated with the patient in either the sitting or the lateral position, and each position has its advantages and disadvantages. Materials and method: This is a Cross sectional and comparative study was conducted in the Department of Anaesthesiology, Chirayu Medical College & Hospital, Bhopal M.P over a period of 1 year.Patients of age group more than 60 years who had to undergo infraumblical surgeries requiring spinal anesthesia at department of Anesthesia at Chirayu Medical College & Hospital, Bhopal were included in the study.Patients were fully informed by investigator in their mother tongue about the anesthetic procedure with the aims and objectives of the study along with a written informed consent was taken from all participants for the study. Result: In our study, Mean SBP was higher in Group-B as compared Group-A, at all-time interval except at 30min. and 40 min. It was also found that statistically insignificant difference were observed at time interval at 30 min.and 40 min. and rest of the interval, statistically significant difference was observed between two groups.(p<0.001).Highest level of sensory block was achieved at T10 and T12 (40% respectively), followed by T8 (20.0%) in group A while in group-B, highest was at T10 (60%) followed by T8 and T12 (20% each). Similarly duration of sensory block was observed 70.8 ±10.02 and 122.8 ±2.74 min. in Group-A and Group-B respectively with highly statistically significant difference (p <0.0001). In all parameters of sensory block higher time values were observed with highly statistically significant difference (p <0.0001). Conclusion: The present study indicates that Induction position for spinal anesthesia does not greatly affect the hemodynamic parameters and block characteristics. However, lateral position appears to be more comfortable for elderly patients in comparison to sitting position undergoing spinal anaesthesia. |
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