Pub Date : 2024-02-08DOI: 10.4103/joacp.joacp_75_22
Saiteja Kodamanchili, Priyanka Tn, A. Anand, Rajesh Panda
{"title":"Catheter mount used as tracheostomy interface in high-flow oxygen therapy","authors":"Saiteja Kodamanchili, Priyanka Tn, A. Anand, Rajesh Panda","doi":"10.4103/joacp.joacp_75_22","DOIUrl":"https://doi.org/10.4103/joacp.joacp_75_22","url":null,"abstract":"","PeriodicalId":508221,"journal":{"name":"Journal of Anaesthesiology Clinical Pharmacology","volume":" 4","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139793306","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-02-08DOI: 10.4103/joacp.joacp_195_22
Dhwani S. Walavalkar, Deepa Kane, Priti S Devalkar, Ramesh Chandan, Nimisha Thakur
{"title":"A curious case of the vanishing bone disease: Anesthesia management","authors":"Dhwani S. Walavalkar, Deepa Kane, Priti S Devalkar, Ramesh Chandan, Nimisha Thakur","doi":"10.4103/joacp.joacp_195_22","DOIUrl":"https://doi.org/10.4103/joacp.joacp_195_22","url":null,"abstract":"","PeriodicalId":508221,"journal":{"name":"Journal of Anaesthesiology Clinical Pharmacology","volume":"121 6","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139794195","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-02-08DOI: 10.4103/joacp.joacp_171_22
S. Maitra, Soumya Sarkar, S. Behera, C. A. Kayina, D. Baidya, B. Ray, Rajeshwari Subramaniam, R. Anand, S. Bhattacharjee
{"title":"Happy hypoxemia in COVID-19 patients: Fact or myth?","authors":"S. Maitra, Soumya Sarkar, S. Behera, C. A. Kayina, D. Baidya, B. Ray, Rajeshwari Subramaniam, R. Anand, S. Bhattacharjee","doi":"10.4103/joacp.joacp_171_22","DOIUrl":"https://doi.org/10.4103/joacp.joacp_171_22","url":null,"abstract":"","PeriodicalId":508221,"journal":{"name":"Journal of Anaesthesiology Clinical Pharmacology","volume":"37 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139853957","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Anesthetic management for aortopexy in an infant with tracheomalacia","authors":"Neha Goyal, Sweta Bharadiya, Deepanshu Dang, Manoj Kamal, Rakesh Kumar","doi":"10.4103/joacp.joacp_110_22","DOIUrl":"https://doi.org/10.4103/joacp.joacp_110_22","url":null,"abstract":"","PeriodicalId":508221,"journal":{"name":"Journal of Anaesthesiology Clinical Pharmacology","volume":"35 S144","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139794460","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Positioning dilemma in a complicated case. Utilizing OT table for ingenious positioning","authors":"Nikita Choudhary, Abhishek Nagarajappa, Puneet Khanna, Sarina Karayi","doi":"10.4103/joacp.joacp_191_22","DOIUrl":"https://doi.org/10.4103/joacp.joacp_191_22","url":null,"abstract":"","PeriodicalId":508221,"journal":{"name":"Journal of Anaesthesiology Clinical Pharmacology","volume":" 26","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139792021","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-02-08DOI: 10.4103/joacp.joacp_171_22
S. Maitra, Soumya Sarkar, S. Behera, C. A. Kayina, D. Baidya, B. Ray, Rajeshwari Subramaniam, R. Anand, S. Bhattacharjee
{"title":"Happy hypoxemia in COVID-19 patients: Fact or myth?","authors":"S. Maitra, Soumya Sarkar, S. Behera, C. A. Kayina, D. Baidya, B. Ray, Rajeshwari Subramaniam, R. Anand, S. Bhattacharjee","doi":"10.4103/joacp.joacp_171_22","DOIUrl":"https://doi.org/10.4103/joacp.joacp_171_22","url":null,"abstract":"","PeriodicalId":508221,"journal":{"name":"Journal of Anaesthesiology Clinical Pharmacology","volume":"83 3","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139794232","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-02-08DOI: 10.4103/joacp.joacp_42_23
Shubha V. Hegde, Archana Shivashankar, K. Nalini, Ashwini Turai
Spinal anesthesia is the safest technique of anesthesia in parturients for cesarean section. Usually, patients are instructed verbally to acquire the ideal position for spinal anesthesia, but there can be difficulty in attaining the best position if patients fail to understand the verbal command, which will lead to detainment in accomplishing the technique and increased possibility of patient’s dissatisfaction. Hence, in our study, we hypothesized that using photographs with verbal commands would reduce the time taken for spinal needle placement, reduce the total number of skin pricks, and improve the success at the first attempt. One hundred and eleven pregnant women undergoing elective cesarean section were divided into Group C (only verbal instructions were given) and Group V (visual aid and verbal instructions were given). Time taken for successful spinal needle placement was noted in seconds and summarized in terms of median and interquartile range. Number of skin punctures, intervertebral spaces attempted, and first-pass success were determined in terms of percentage. Pearson’s Chi-square test was used to compare the above parameters between the two groups. There was significant reduction in the time taken for spinal needle placement in Group V compared to the control group. There was significant improvement in first-pass success rate and reduction in the number of skin pricks and intervertebral spaces attempted in Group V. Use of visual aid with verbal commands helps in better understanding of positioning, thus improving the first-pass success significantly. It also reduces the duration for successful spinal needle placement, number of skin pricks, and intervertebral spaces attempted.
脊髓麻醉是剖宫产产妇最安全的麻醉技术。通常情况下，患者会在口头指导下获得脊髓麻醉的理想体位，但如果患者无法理解口头指令，就很难获得最佳体位，这将导致患者无法完成技术，并增加患者不满意的可能性。因此，在我们的研究中，我们假设使用照片配合口头指令可以缩短脊髓穿刺针置入的时间，减少皮肤刺入的总次数，并提高首次尝试的成功率。 111 名接受择期剖腹产手术的孕妇被分为 C 组（仅提供口头指导）和 V 组（提供视觉辅助和口头指导）。以秒为单位记录成功置入脊髓针所需的时间，并以中位数和四分位数间距进行总结。皮肤穿刺次数、尝试的椎间隙数和首次穿刺成功率按百分比计算。采用皮尔逊卡方检验比较两组患者的上述参数。 与对照组相比，第五组的脊髓穿刺针置入时间明显缩短。使用视觉辅助工具和口头指令有助于更好地理解定位，从而大大提高了首次穿刺的成功率。它还缩短了脊髓穿刺针成功放置的时间，减少了皮肤穿刺次数和椎间隙尝试次数。
{"title":"Optimal patient positioning for spinal anesthesia using a visual aid in cesarean section patients: A randomized control trial","authors":"Shubha V. Hegde, Archana Shivashankar, K. Nalini, Ashwini Turai","doi":"10.4103/joacp.joacp_42_23","DOIUrl":"https://doi.org/10.4103/joacp.joacp_42_23","url":null,"abstract":"\u0000 \u0000 \u0000 Spinal anesthesia is the safest technique of anesthesia in parturients for cesarean section. Usually, patients are instructed verbally to acquire the ideal position for spinal anesthesia, but there can be difficulty in attaining the best position if patients fail to understand the verbal command, which will lead to detainment in accomplishing the technique and increased possibility of patient’s dissatisfaction. Hence, in our study, we hypothesized that using photographs with verbal commands would reduce the time taken for spinal needle placement, reduce the total number of skin pricks, and improve the success at the first attempt.\u0000 \u0000 \u0000 \u0000 One hundred and eleven pregnant women undergoing elective cesarean section were divided into Group C (only verbal instructions were given) and Group V (visual aid and verbal instructions were given). Time taken for successful spinal needle placement was noted in seconds and summarized in terms of median and interquartile range. Number of skin punctures, intervertebral spaces attempted, and first-pass success were determined in terms of percentage. Pearson’s Chi-square test was used to compare the above parameters between the two groups.\u0000 \u0000 \u0000 \u0000 There was significant reduction in the time taken for spinal needle placement in Group V compared to the control group. There was significant improvement in first-pass success rate and reduction in the number of skin pricks and intervertebral spaces attempted in Group V.\u0000 \u0000 \u0000 \u0000 Use of visual aid with verbal commands helps in better understanding of positioning, thus improving the first-pass success significantly. It also reduces the duration for successful spinal needle placement, number of skin pricks, and intervertebral spaces attempted.\u0000","PeriodicalId":508221,"journal":{"name":"Journal of Anaesthesiology Clinical Pharmacology","volume":" 11","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139791610","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Starvation of long duration during third trimester of pregnancy is undesirable as it is associated with accelerated fasting leading to hypoglycemia, raised plasma free fatty acid (FFA) levels, and increased plasma/urinary ketones. Carbohydrate (CHO)-rich drinks given preoperatively may ameliorate these deleterious effects. The enhanced recovery after surgery (ERAS) guidelines for perioperative care recommend that oral CHO fluid supplementation 2 h before cesarean delivery may be offered to nondiabetic pregnant women. The aim of the study was to evaluate the role of preoperative oral CHO loading for the prevention of perioperative ketoacidosis in elective cesarean deliveries. One hundred and twenty American Society of Anesthesiologists (ASA) II/III parturients undergoing elective cesarean section under subarachnoid block (SAB) were divided into two groups of 60 each after they gave written informed consent. Group A parturients received 400 ml of filtered water 2 h before surgery. Group B parturients received 400 ml of nonparticulate CHO drink 2 h before surgery. The primary outcome was the incidence of ketonuria studied by the dipstick method. Secondary outcomes included hunger and thirst scores, anxiety score, dominant hand grip strength, and the quality of recovery score. The urine ketone levels were positive (+1) in 8.3% parturients in group A and 1.7% parturients in the CHO group (P value- 0.094). The hunger and thirst scores as well as the modified Beck’s anxiety scores were significantly lower in the CHO group (P value- 0.002). Dominant hand grip strength was preserved in both the groups (P value- 0.827). The quality of recovery score was significantly improved in the CHO group (P value- 0.002). No serious adverse effects were noted in either group. Oral CHO drink is safe when administered 2 h before uncomplicated elective cesarean deliveries. It may have a positive influence on a wide range of perioperative markers of clinical outcome.
在妊娠三个月内长时间饥饿是不可取的，因为这会加速禁食，导致低血糖、血浆游离脂肪酸（FFA）水平升高以及血浆/尿酮体增加。术前饮用富含碳水化合物（CHO）的饮料可减轻这些有害影响。加强术后恢复（ERAS）围术期护理指南建议，可在剖宫产前 2 小时为非糖尿病孕妇提供口服 CHO 补充液。本研究旨在评估术前口服 CHO 补充剂对预防择期剖宫产围手术期酮症酸中毒的作用。 120名美国麻醉医师协会（ASA）II/III级产妇在蛛网膜下腔阻滞（SAB）下接受择期剖宫产手术，在获得书面知情同意后被分为两组，每组60人。A 组产妇在术前 2 小时饮用 400 毫升过滤水。B 组产妇在手术前 2 小时饮用 400 毫升无颗粒 CHO 饮料。主要结果是用量尺法检测酮尿的发生率。次要结果包括饥饿和口渴评分、焦虑评分、优势手握力和恢复质量评分。 尿酮水平呈阳性（+1）的 A 组产妇占 8.3%，CHO 组产妇占 1.7%（P 值为 0.094）。CHO 组的饥饿和口渴评分以及改良贝克焦虑评分均显著降低（P 值- 0.002）。两组患者的惯用手握力均保持不变（P 值- 0.827）。CHO 组的康复质量评分明显提高（P 值- 0.002）。两组均未发现严重不良反应。 在无并发症的择期剖宫产前 2 小时口服 CHO 饮料是安全的。口服 CHO 饮料可能对围术期临床结果的各种指标产生积极影响。
{"title":"Role of preoperative carbohydrate loading for prevention of perioperative ketoacidosis in elective cesarean delivery","authors":"Ankita Sharma, Udeyana Singh, Gurpreeti Kaur, Anju Grewal, S. Maingi, Swati Tidyal","doi":"10.4103/joacp.joacp_172_23","DOIUrl":"https://doi.org/10.4103/joacp.joacp_172_23","url":null,"abstract":"\u0000 \u0000 \u0000 Starvation of long duration during third trimester of pregnancy is undesirable as it is associated with accelerated fasting leading to hypoglycemia, raised plasma free fatty acid (FFA) levels, and increased plasma/urinary ketones. Carbohydrate (CHO)-rich drinks given preoperatively may ameliorate these deleterious effects. The enhanced recovery after surgery (ERAS) guidelines for perioperative care recommend that oral CHO fluid supplementation 2 h before cesarean delivery may be offered to nondiabetic pregnant women. The aim of the study was to evaluate the role of preoperative oral CHO loading for the prevention of perioperative ketoacidosis in elective cesarean deliveries.\u0000 \u0000 \u0000 \u0000 One hundred and twenty American Society of Anesthesiologists (ASA) II/III parturients undergoing elective cesarean section under subarachnoid block (SAB) were divided into two groups of 60 each after they gave written informed consent. Group A parturients received 400 ml of filtered water 2 h before surgery. Group B parturients received 400 ml of nonparticulate CHO drink 2 h before surgery. The primary outcome was the incidence of ketonuria studied by the dipstick method. Secondary outcomes included hunger and thirst scores, anxiety score, dominant hand grip strength, and the quality of recovery score.\u0000 \u0000 \u0000 \u0000 The urine ketone levels were positive (+1) in 8.3% parturients in group A and 1.7% parturients in the CHO group (P value- 0.094). The hunger and thirst scores as well as the modified Beck’s anxiety scores were significantly lower in the CHO group (P value- 0.002). Dominant hand grip strength was preserved in both the groups (P value- 0.827). The quality of recovery score was significantly improved in the CHO group (P value- 0.002). No serious adverse effects were noted in either group.\u0000 \u0000 \u0000 \u0000 Oral CHO drink is safe when administered 2 h before uncomplicated elective cesarean deliveries. It may have a positive influence on a wide range of perioperative markers of clinical outcome.\u0000","PeriodicalId":508221,"journal":{"name":"Journal of Anaesthesiology Clinical Pharmacology","volume":" 32","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139792393","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-02-08DOI: 10.4103/joacp.joacp_42_23
Shubha V. Hegde, Archana Shivashankar, K. Nalini, Ashwini Turai
Spinal anesthesia is the safest technique of anesthesia in parturients for cesarean section. Usually, patients are instructed verbally to acquire the ideal position for spinal anesthesia, but there can be difficulty in attaining the best position if patients fail to understand the verbal command, which will lead to detainment in accomplishing the technique and increased possibility of patient’s dissatisfaction. Hence, in our study, we hypothesized that using photographs with verbal commands would reduce the time taken for spinal needle placement, reduce the total number of skin pricks, and improve the success at the first attempt. One hundred and eleven pregnant women undergoing elective cesarean section were divided into Group C (only verbal instructions were given) and Group V (visual aid and verbal instructions were given). Time taken for successful spinal needle placement was noted in seconds and summarized in terms of median and interquartile range. Number of skin punctures, intervertebral spaces attempted, and first-pass success were determined in terms of percentage. Pearson’s Chi-square test was used to compare the above parameters between the two groups. There was significant reduction in the time taken for spinal needle placement in Group V compared to the control group. There was significant improvement in first-pass success rate and reduction in the number of skin pricks and intervertebral spaces attempted in Group V. Use of visual aid with verbal commands helps in better understanding of positioning, thus improving the first-pass success significantly. It also reduces the duration for successful spinal needle placement, number of skin pricks, and intervertebral spaces attempted.
脊髓麻醉是剖宫产产妇最安全的麻醉技术。通常情况下，患者会在口头指导下获得脊髓麻醉的理想体位，但如果患者无法理解口头指令，就很难获得最佳体位，这将导致患者无法完成技术，并增加患者不满意的可能性。因此，在我们的研究中，我们假设使用照片配合口头指令可以缩短脊髓穿刺针置入的时间，减少皮肤刺入的总次数，并提高首次尝试的成功率。 111 名接受择期剖腹产手术的孕妇被分为 C 组（仅提供口头指导）和 V 组（提供视觉辅助和口头指导）。以秒为单位记录成功置入脊髓针所需的时间，并以中位数和四分位数间距进行总结。皮肤穿刺次数、尝试的椎间隙数和首次穿刺成功率按百分比计算。采用皮尔逊卡方检验比较两组患者的上述参数。 与对照组相比，第五组的脊髓穿刺针置入时间明显缩短。使用视觉辅助工具和口头指令有助于更好地理解定位，从而大大提高了首次穿刺的成功率。它还缩短了脊髓穿刺针成功放置的时间，减少了皮肤穿刺次数和椎间隙尝试次数。
{"title":"Optimal patient positioning for spinal anesthesia using a visual aid in cesarean section patients: A randomized control trial","authors":"Shubha V. Hegde, Archana Shivashankar, K. Nalini, Ashwini Turai","doi":"10.4103/joacp.joacp_42_23","DOIUrl":"https://doi.org/10.4103/joacp.joacp_42_23","url":null,"abstract":"\u0000 \u0000 \u0000 Spinal anesthesia is the safest technique of anesthesia in parturients for cesarean section. Usually, patients are instructed verbally to acquire the ideal position for spinal anesthesia, but there can be difficulty in attaining the best position if patients fail to understand the verbal command, which will lead to detainment in accomplishing the technique and increased possibility of patient’s dissatisfaction. Hence, in our study, we hypothesized that using photographs with verbal commands would reduce the time taken for spinal needle placement, reduce the total number of skin pricks, and improve the success at the first attempt.\u0000 \u0000 \u0000 \u0000 One hundred and eleven pregnant women undergoing elective cesarean section were divided into Group C (only verbal instructions were given) and Group V (visual aid and verbal instructions were given). Time taken for successful spinal needle placement was noted in seconds and summarized in terms of median and interquartile range. Number of skin punctures, intervertebral spaces attempted, and first-pass success were determined in terms of percentage. Pearson’s Chi-square test was used to compare the above parameters between the two groups.\u0000 \u0000 \u0000 \u0000 There was significant reduction in the time taken for spinal needle placement in Group V compared to the control group. There was significant improvement in first-pass success rate and reduction in the number of skin pricks and intervertebral spaces attempted in Group V.\u0000 \u0000 \u0000 \u0000 Use of visual aid with verbal commands helps in better understanding of positioning, thus improving the first-pass success significantly. It also reduces the duration for successful spinal needle placement, number of skin pricks, and intervertebral spaces attempted.\u0000","PeriodicalId":508221,"journal":{"name":"Journal of Anaesthesiology Clinical Pharmacology","volume":"13 5","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139851384","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-02-08DOI: 10.4103/joacp.joacp_11_22
N. Puthenveettil, Sajan Rahman, Arun Ramayyan Achary, Sobha S. Nair, Dilesh Kadapamannil, Jerry Paul
The position of the patient during subarachnoid block has a role in its success. Landmarks of the spine can be easily identified in sitting position. Sitting position with legs parallel (LPSP) produces a reversal of lumbar lordosis. The crossed-leg sitting position (CLSP) is an alternative position. In this study, we compared the ease of performing subarachnoid blocks in these two positions. The objectives were to compare the attempts at subarachnoid placement, patient comfort, ease of landmark palpation, level of block, hypotension, and neonatal outcomes. This randomized trial was performed in 80 parturients posted for elective cesarean section. Parturients were assigned randomly to two groups. In group LPSP, the subarachnoid block was performed in sitting position with legs parallel and in group CLSP in the CLSP with knees and hips flexed. The percentage of parturients with a successful subarachnoid block in the first attempt was higher in the CLSP than in LPSP group (87.5% versus 55%). The remaining 12.5% parturients in the CLSP group had successful block in the second attempt. In the LPSP group, 32.5% required two attempts and 12.5% required more than two attempts. This difference was statistically significant (P-value of 0.003). The landmark was easily palpable in 92.5 versus 67.5% of parturients in CLSP and LPSP, respectively, with a P-value of 0.014. CLSP is better than a sitting position with legs parallel for reducing the number of attempts and improving the ease of performing the subarachnoid block.
{"title":"Comparison of induction of spinal anesthesia in sitting position with legs parallel and crossed for cesarean section: A randomized controlled trial","authors":"N. Puthenveettil, Sajan Rahman, Arun Ramayyan Achary, Sobha S. Nair, Dilesh Kadapamannil, Jerry Paul","doi":"10.4103/joacp.joacp_11_22","DOIUrl":"https://doi.org/10.4103/joacp.joacp_11_22","url":null,"abstract":"\u0000 \u0000 \u0000 The position of the patient during subarachnoid block has a role in its success. Landmarks of the spine can be easily identified in sitting position. Sitting position with legs parallel (LPSP) produces a reversal of lumbar lordosis. The crossed-leg sitting position (CLSP) is an alternative position. In this study, we compared the ease of performing subarachnoid blocks in these two positions. The objectives were to compare the attempts at subarachnoid placement, patient comfort, ease of landmark palpation, level of block, hypotension, and neonatal outcomes.\u0000 \u0000 \u0000 \u0000 This randomized trial was performed in 80 parturients posted for elective cesarean section. Parturients were assigned randomly to two groups. In group LPSP, the subarachnoid block was performed in sitting position with legs parallel and in group CLSP in the CLSP with knees and hips flexed.\u0000 \u0000 \u0000 \u0000 The percentage of parturients with a successful subarachnoid block in the first attempt was higher in the CLSP than in LPSP group (87.5% versus 55%). The remaining 12.5% parturients in the CLSP group had successful block in the second attempt. In the LPSP group, 32.5% required two attempts and 12.5% required more than two attempts. This difference was statistically significant (P-value of 0.003). The landmark was easily palpable in 92.5 versus 67.5% of parturients in CLSP and LPSP, respectively, with a P-value of 0.014.\u0000 \u0000 \u0000 \u0000 CLSP is better than a sitting position with legs parallel for reducing the number of attempts and improving the ease of performing the subarachnoid block.\u0000","PeriodicalId":508221,"journal":{"name":"Journal of Anaesthesiology Clinical Pharmacology","volume":"90 3","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139851419","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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