AI Summary & Key Takeaways
AI InsightAlthough there is evidence in the literature that the spinal anesthesia applied in LD position is found to be more beneficial in terms of PSHA, there was no difference in the incidence of PSHA between the groups in our study.
📌 3 Key Takeaways
Abstract
Objective: Spinal anesthesia is often preferred method of anesthesia form of any different medical procedures, especially lower extremity surgery. Spinal anesthesia is often applied in patients with the lateral decubitus (LD) or sitting position. In our study, we aimed to investigate the effects of spinal anesthesia application with lateral decubitus or sitting position on the intraoperative hemodynamics, duration of mobilization and postspinal headache (PSHA). Method: A total of 138 patients with ASA physical status I-II, aged 18-65 years scheduled for elective lower extremity surgery were included in the study at Karadeniz Technical University Hospital between July 2015 and January 2016. Patients were randomly divided into two groups: lateral decubitus (Group LD, n = 70) and sitting (Group O, n = 68) position with spinal anesthesia. After both groups were administered with a standard 0.5% 3 ml hyperbaric bupivacaine by a spinal block, pre-block (T 0 ) and after block (T 1,5,10,15,30,60,120 ) mean arterial pressure (MAP), heart rate (HR), peripheral oxygen saturation (SpO 2 ), and Bromage III score which is the absolutly effective motor block level were recorded at spesific time intervals. In the postoperative period, motor block returning time to Bromage 0 and the frequency of PSHA were observed and compared between the groups. A value of p 0.05). Conclusion: We think that the spinal anesthesia done in the LD position is a more suitable choice because of the faster access to the Bromage III score which is the effective motor block level, and the faster reversal of the motor block. Although there is evidence in the literature that the spinal anesthesia applied in LD position is found to be more beneficial in terms of PSHA, there was no difference in the incidence of PSHA between the groups in our study.
Özet
Amaç: Spinal anestezi özellikle alt ekstremite cerrahisi gibi birçok farkl› t›bbi prosedür için s›kl›kla tercih edilen bir anestezi yöntemidir. Spinal anestezi, hastalara s›kl›kla lateral dekübit (LD) veya oturur pozisyonda uygulanmaktad›r. Çal›flmam›zda, LD veya oturur pozisyonda uygulanan spinal anestezinin intraoperatif hemodinami, mobilizasyon süresi ve postspinal bafl a¤r›s›na (PSBA) olan etkilerini araflt›rmay› amaçlad›k. Yöntem: Çal›flmaya Temmuz 2015-Ocak 2016 tarihleri aras›nda Karadeniz Teknik Üniversitesi T›p Fakültesi Hastanesinde, elektif alt ekstremite cerrahisi planlanan 18-65 yafl aras›ndaki,ASA fiziksel statüsü I-II risk grubundaki toplam 138 hasta dahil edildi. Hastalar rastgele olarak lateral dekübit (Grup LD, n=70) veya oturur (Grup O, n=68) pozisyonda spinal anestezi uygulanmak üzere ikiye ayr›ld›. Her iki gruba da standart olarak %0,5’lik 3ml hiperbarik bupivakain ile spinal blok yap›ld›ktan sonra, blok öncesi (T 0 ) ve blok sonras› belirli zaman aral›klar› ile (T 1,5,10,15,30,60,120 ) ortalama arteriyel bas›nç (OAB), kalp at›m h›z› (KAH), oksijen satürasyonu (SpO 2 ) ve etkin motor blok seviyesi olarak kabul etti¤imiz Bromage III skoruna ulaflma süresi ölçüldü. Postoperatif dönemde gruplar›n motor blo¤un tamamen geri döndü¤ü Bromage 0’a ulaflma süresi ve PSBA görülme s›kl›¤› karfl›laflt›r›ld›. p 0.05). Sonuç: Çal›flmam›zda LD pozisyonunda yap›lan spinal anestezinin, etkin motor blok düzeyi olan Bromage III skoruna h›zla ulaflmas› ve motor blo¤un daha h›zl› geri dönmesi nedeniyle daha uygun bir tercih oldu¤unu düflünüyoruz. Literatürde LD pozisyonunda uygulanan spinal anestezinin PSBA yönünden daha yararl› bulundu¤una dair kan›tlar mevcut olsa da çal›flmam›zda gruplar aras›nda PSBA insidans› aç›s›ndan fark saptanmam›flt›r.