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Prevention of phantom sensations after spinal anesthesia
Anchalee Techanivate1, Pornthip Ultchaswadi, Ekachai Chaedamphai
1Department of Anesthesiology, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand.
Summary
Minimizing phantom limb sensation (PLS) after spinal anesthesia is possible. Keeping lower limbs neutral until the L1 dermatome level significantly reduces PLS incidence compared to the T6 level.
Area of Science:
- Anesthesiology
- Neurosurgery
- Pain Management
Background:
- Phantom limb sensation (PLS) is a common and distressing complication following spinal anesthesia.
- Previous studies reported high incidence rates of PLS, ranging from 80% to 83%.
Purpose of the Study:
- To evaluate the incidence of PLS after spinal anesthesia.
- To compare the occurrence of PLS between two groups based on analgesic spread: L1 dermatome and T6 dermatome.
Main Methods:
- Ninety patients undergoing lower abdominal surgery under spinal anesthesia were divided into two groups.
- One lower limb was flexed, and the other kept straight; limbs were returned to neutral at L1 or T6 analgesic levels.
- Patient satisfaction and limb sensation were assessed post-procedure.
Main Results:
- The L1 group showed a significantly lower incidence of PLS (20%) compared to the T6 group (82.2%).
- No dissatisfaction with PLS was reported in the L1 group, whereas 11.1% of the T6 group expressed dissatisfaction.
Conclusions:
- Neutral positioning of lower limbs immediately post-spinal injection can effectively minimize phantom limb sensation.
- Early intervention before sensory memory consolidation is key to reducing PLS after spinal anesthesia.
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