Knee-chest vs horizontal side position during induction of spinal anaesthesia in patients undergoing lumbar disc surgery

British Journal of Anaesthesia
E LaaksoP H Rosenberg

Abstract

In the prone knee-chest position the spread of plain 0.5% bupivacaine in the cerebrospinal fluid and associated haemodynamic changes may be different compared with the horizontal position. A randomized comparison was performed in 40 ASA I-II patients, aged 24-61 yr, undergoing lumbar disc surgery. Subarachnoid injection (27-gauge needle) at the L2-3 interspace with 3 ml of 0.5% bupivacaine was performed with the patient in the operative knee-chest position (prone knee-chest group, n = 20) or in the horizontal side position (supine side horizontal group, n = 20). Patients in the supine side horizontal group were turned into the horizontal supine position for 20 min, and subsequently they were placed in the operative knee-chest position. In three patients in the prone knee-chest group, the spinal needle was replaced by a larger needle (25-gauge). The final cephalad extension of sensory analgesia on skin tested by pinprick was T5 (median) in the prone knee-chest group and T6 in the supine side horizontal group. Recovery was also similar, on average 210 min from injection in both groups. The mean decrease in systolic arterial pressure was somewhat greater in the prone knee-chest group (30 mm Hg) than in the supine side horizontal g...Continue Reading

Citations

Oct 9, 2008·Canadian Journal of Anaesthesia = Journal Canadien D'anesthésie·Yehuda GinosarElyad Davidson
Feb 28, 2009·Canadian Journal of Anaesthesia = Journal Canadien D'anesthésie·Dolores McKeenRomesh Shukla
Jun 24, 2006·Anaesthesia·M GoddardA C Howard
Nov 25, 2003·Regional Anesthesia and Pain Medicine·Jin-Tae KimJae-Hyon Bahk
Jul 11, 1998·Anaesthesia·M Pitkänen
Sep 2, 1999·Anaesthesia and Intensive Care·D J Gattas, L S Weber
Oct 13, 2020·Clinical Spine Surgery : a Spine Publication·Bhavuk GargAlok D Sharan
Jun 15, 2021·JBJS Reviews·Bhavuk GargAlok D Sharan

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