Analysis of modified sitting positions for subarachnoid block: A prospective observational study
Background: Neuraxial block is one of the most common anesthetic modalities for a wide range of surgical procedures. Conventionally, it is mostly performed in classical sitting position (CSP), however, a few modifications of sitting position have been described in literature since patient positionin...
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Manipal College of Medical Sciences, Pokhara
2025-02-01
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| Series: | Asian Journal of Medical Sciences |
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| Online Access: | https://ajmsjournal.info/index.php/AJMS/article/view/4357 |
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| author | Nousheen Chowdhary Ajaiz Rasool Raja Suhail Shounthoo Majid Jehangir Rohey Jan Showkat Ahmad Gurcoo |
| author_facet | Nousheen Chowdhary Ajaiz Rasool Raja Suhail Shounthoo Majid Jehangir Rohey Jan Showkat Ahmad Gurcoo |
| author_sort | Nousheen Chowdhary |
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| description | Background: Neuraxial block is one of the most common anesthetic modalities for a wide range of surgical procedures. Conventionally, it is mostly performed in classical sitting position (CSP), however, a few modifications of sitting position have been described in literature since patient positioning is by far the most crucial factor for a successful subarachnoid block (SAB). Proper positioning of the patients reduces lumbar lordosis and facilitates easy palpation of the landmarks.
Aims and Objectives: Comparison of three different sitting positions including classical sitting position (CSP), hamstring stretch position (HSP), and riders sitting position (RSP), for SAB.
Materials and Methods: A total of 207 patients, divided equally into three groups (CSP, HSP and RSP) with 69 patients in each group. Spinal anesthesia was given in three different sitting positions, and the parameters were recorded with respect to time taken for intrathecal placement of the needle, number of punctures, ease of palpation of space, patient comfort, and anesthesiologists’ satisfaction.
Results: Confirmation of subarachnoid placement of needle required the least time in RSP group (P=0.003), majority of patients in RSP required a single skin puncture (P=0.0237), clarity of the bony landmarks was similar in all the three positions (P=0.108), patients’ satisfaction score was highest in CSP group (P=0.012); however, anesthesiologists’ reported higher satisfaction levels in RSP group, although results were statistically non-significant (P=0.739).
Conclusion: From the anesthetist’s standpoint, RSP was the most favorable position for spinal anesthesia, however, the majority of patients reported better comfort levels with CSP. |
| format | Article |
| id | doaj-art-cb2961530f1847ee80f1588931a16c20 |
| institution | Kabale University |
| issn | 2467-9100 2091-0576 |
| language | English |
| publishDate | 2025-02-01 |
| publisher | Manipal College of Medical Sciences, Pokhara |
| record_format | Article |
| series | Asian Journal of Medical Sciences |
| spelling | doaj-art-cb2961530f1847ee80f1588931a16c202025-02-01T07:49:06ZengManipal College of Medical Sciences, PokharaAsian Journal of Medical Sciences2467-91002091-05762025-02-011622024https://doi.org/10.71152/ajms.v16i2.4357Analysis of modified sitting positions for subarachnoid block: A prospective observational studyNousheen Chowdhary 0https://orcid.org/0009-0009-2523-5678Ajaiz Rasool 1https://orcid.org/0009-0001-7259-4755Raja Suhail Shounthoo 2https://orcid.org/0009-0008-3833-4053Majid Jehangir 3https://orcid.org/0000-0001-5130-4889Rohey Jan 4https://orcid.org/0009-0001-0481-5800Showkat Ahmad Gurcoo 5https://orcid.org/0000-0001-7873-3552Postgraduate Resident, Department of Anaesthesiology, Sheri Kashmir Institute of Medical Sciences, Srinagar, Jammu and Kashmir, India Assistant Professor, Department of Anaesthesiology, Sheri Kashmir Institute of Medical Sciences, Srinagar, Jammu and Kashmir, India Assistant Professor, Department of Anaesthesiology, Sheri Kashmir Institute of Medical Sciences, Srinagar, Jammu and Kashmir, India Assistant Professor, Department of Anaesthesiology, Sheri Kashmir Institute of Medical Sciences, Srinagar, Jammu and Kashmir, India Assistant Professor, Department of Anaesthesiology, Sheri Kashmir Institute of Medical Sciences, Srinagar, Jammu and Kashmir, India Professor and Head, Department of Anaesthesiology, Sheri Kashmir Institute of Medical Sciences, Srinagar, Jammu and Kashmir, India Background: Neuraxial block is one of the most common anesthetic modalities for a wide range of surgical procedures. Conventionally, it is mostly performed in classical sitting position (CSP), however, a few modifications of sitting position have been described in literature since patient positioning is by far the most crucial factor for a successful subarachnoid block (SAB). Proper positioning of the patients reduces lumbar lordosis and facilitates easy palpation of the landmarks. Aims and Objectives: Comparison of three different sitting positions including classical sitting position (CSP), hamstring stretch position (HSP), and riders sitting position (RSP), for SAB. Materials and Methods: A total of 207 patients, divided equally into three groups (CSP, HSP and RSP) with 69 patients in each group. Spinal anesthesia was given in three different sitting positions, and the parameters were recorded with respect to time taken for intrathecal placement of the needle, number of punctures, ease of palpation of space, patient comfort, and anesthesiologists’ satisfaction. Results: Confirmation of subarachnoid placement of needle required the least time in RSP group (P=0.003), majority of patients in RSP required a single skin puncture (P=0.0237), clarity of the bony landmarks was similar in all the three positions (P=0.108), patients’ satisfaction score was highest in CSP group (P=0.012); however, anesthesiologists’ reported higher satisfaction levels in RSP group, although results were statistically non-significant (P=0.739). Conclusion: From the anesthetist’s standpoint, RSP was the most favorable position for spinal anesthesia, however, the majority of patients reported better comfort levels with CSP.https://ajmsjournal.info/index.php/AJMS/article/view/4357subarachnoid block; spinal anesthesia; patient positioningclassical sitting position; hamstring stretch position; riders sitting position |
| spellingShingle | Nousheen Chowdhary Ajaiz Rasool Raja Suhail Shounthoo Majid Jehangir Rohey Jan Showkat Ahmad Gurcoo Analysis of modified sitting positions for subarachnoid block: A prospective observational study Asian Journal of Medical Sciences subarachnoid block; spinal anesthesia; patient positioning classical sitting position; hamstring stretch position; riders sitting position |
| title | Analysis of modified sitting positions for subarachnoid block: A prospective observational study |
| title_full | Analysis of modified sitting positions for subarachnoid block: A prospective observational study |
| title_fullStr | Analysis of modified sitting positions for subarachnoid block: A prospective observational study |
| title_full_unstemmed | Analysis of modified sitting positions for subarachnoid block: A prospective observational study |
| title_short | Analysis of modified sitting positions for subarachnoid block: A prospective observational study |
| title_sort | analysis of modified sitting positions for subarachnoid block a prospective observational study |
| topic | subarachnoid block; spinal anesthesia; patient positioning classical sitting position; hamstring stretch position; riders sitting position |
| url | https://ajmsjournal.info/index.php/AJMS/article/view/4357 |
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