Comparison of three sitting positions for combined spinal - epidural anesthesia: a multicenter randomized controlled trial
Background and objectives: The aim of this prospective, multi-centered and multi-arm parallel randomized trial was to test the hypothesis that modified sitting positions including hamstring stretch position (HSP) and squatting position (SP) would reduce needle - bone contact events and increase the...
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| Format: | Article |
| Language: | English |
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Elsevier
2021-03-01
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| Series: | Brazilian Journal of Anesthesiology |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S0104001420302219 |
| _version_ | 1811201276260646912 |
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| author | Mehmet Özgür Özhan Ceyda Özhan Çaparlar Mehmet Anıl Süzer Mehmet Burak Eskin Bülent Atik |
| author_facet | Mehmet Özgür Özhan Ceyda Özhan Çaparlar Mehmet Anıl Süzer Mehmet Burak Eskin Bülent Atik |
| author_sort | Mehmet Özgür Özhan |
| collection | DOAJ |
| description | Background and objectives: The aim of this prospective, multi-centered and multi-arm parallel randomized trial was to test the hypothesis that modified sitting positions including hamstring stretch position (HSP) and squatting position (SP) would reduce needle - bone contact events and increase the success rate of combined spinal - epidural anesthesia (CSEA) compared to traditional sitting position (TSP) in patients undergoing total knee or hip arthroplasty. Patients and methods: Three hundred and sixty American Society of Anesthesiologists (ASA) I-III patients, aged between 45-85 years were randomly allocated to one of three groups using computer-generated simple randomization: group TSP (n = 120), group HSP (n = 120), and group SP (n = 120). Primary outcome measures were the number of needle-bone contact and success rates. Secondary outcome measure was the ease of interspinous space identification. Results: Seven patients in group SP and four of HSP could not tolerate their position and were excluded. Number of needle-bone contact, success rates, and grade of interspinous space identification were similar between groups (p = 1.000). Independent of positioning, the success rates were higher in patients whose interspinous space was graded as easy compared to difficult or impossible (p < 0.001). Success rates reduced, interspinous space identification became more challenging, and number of needle – bone contact increased as patient’s body mass index (BMI) increased (p < 0.001). Conclusion: SP and HSP may be used as alternatives to the TSP. BMI and ease of interspinous space identification may be considered important determinants for CSEA success. |
| first_indexed | 2024-04-12T02:19:22Z |
| format | Article |
| id | doaj.art-c7748575a93e431eb1e2886d10a326f8 |
| institution | Directory Open Access Journal |
| issn | 0104-0014 |
| language | English |
| last_indexed | 2024-04-12T02:19:22Z |
| publishDate | 2021-03-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Brazilian Journal of Anesthesiology |
| spelling | doaj.art-c7748575a93e431eb1e2886d10a326f82022-12-22T03:52:10ZengElsevierBrazilian Journal of Anesthesiology0104-00142021-03-01712129136Comparison of three sitting positions for combined spinal - epidural anesthesia: a multicenter randomized controlled trialMehmet Özgür Özhan0Ceyda Özhan Çaparlar1Mehmet Anıl Süzer2Mehmet Burak Eskin3Bülent Atik4Private Çankaya Hospital, Department of Anesthesiology and Reanimation, Ankara, TurkeyUniversity of Medical Sciences Yildirim Beyazit Training and Research Hospital, Department of Anesthesiology and Reanimation, Ankara, TurkeyPrivate Çankaya Hospital, Department of Anesthesiology and Reanimation, Ankara, TurkeyUniversity of Medical Sciences Gulhane Training and Research Hospital, Department of Anesthesiology and Reanimation, Ankara, TurkeyBalikesir University Medical Faculty Health Practice and Research Hospital, Department of Anesthesiology and Reanimation, Balikesir, Turkey; Corresponding author.Background and objectives: The aim of this prospective, multi-centered and multi-arm parallel randomized trial was to test the hypothesis that modified sitting positions including hamstring stretch position (HSP) and squatting position (SP) would reduce needle - bone contact events and increase the success rate of combined spinal - epidural anesthesia (CSEA) compared to traditional sitting position (TSP) in patients undergoing total knee or hip arthroplasty. Patients and methods: Three hundred and sixty American Society of Anesthesiologists (ASA) I-III patients, aged between 45-85 years were randomly allocated to one of three groups using computer-generated simple randomization: group TSP (n = 120), group HSP (n = 120), and group SP (n = 120). Primary outcome measures were the number of needle-bone contact and success rates. Secondary outcome measure was the ease of interspinous space identification. Results: Seven patients in group SP and four of HSP could not tolerate their position and were excluded. Number of needle-bone contact, success rates, and grade of interspinous space identification were similar between groups (p = 1.000). Independent of positioning, the success rates were higher in patients whose interspinous space was graded as easy compared to difficult or impossible (p < 0.001). Success rates reduced, interspinous space identification became more challenging, and number of needle – bone contact increased as patient’s body mass index (BMI) increased (p < 0.001). Conclusion: SP and HSP may be used as alternatives to the TSP. BMI and ease of interspinous space identification may be considered important determinants for CSEA success.http://www.sciencedirect.com/science/article/pii/S0104001420302219Traditional sitting positionHamstring stretch positionSquatting positionCombined spinal epidural anesthesiaArthroplasty |
| spellingShingle | Mehmet Özgür Özhan Ceyda Özhan Çaparlar Mehmet Anıl Süzer Mehmet Burak Eskin Bülent Atik Comparison of three sitting positions for combined spinal - epidural anesthesia: a multicenter randomized controlled trial Brazilian Journal of Anesthesiology Traditional sitting position Hamstring stretch position Squatting position Combined spinal epidural anesthesia Arthroplasty |
| title | Comparison of three sitting positions for combined spinal - epidural anesthesia: a multicenter randomized controlled trial |
| title_full | Comparison of three sitting positions for combined spinal - epidural anesthesia: a multicenter randomized controlled trial |
| title_fullStr | Comparison of three sitting positions for combined spinal - epidural anesthesia: a multicenter randomized controlled trial |
| title_full_unstemmed | Comparison of three sitting positions for combined spinal - epidural anesthesia: a multicenter randomized controlled trial |
| title_short | Comparison of three sitting positions for combined spinal - epidural anesthesia: a multicenter randomized controlled trial |
| title_sort | comparison of three sitting positions for combined spinal epidural anesthesia a multicenter randomized controlled trial |
| topic | Traditional sitting position Hamstring stretch position Squatting position Combined spinal epidural anesthesia Arthroplasty |
| url | http://www.sciencedirect.com/science/article/pii/S0104001420302219 |
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