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Related Concept Videos

Local Anesthetics: Clinical Application as Spinal Anesthesia01:11

Local Anesthetics: Clinical Application as Spinal Anesthesia

Spinal anesthetics are given during lower abdomen and limb surgeries to block sensory and motor neurons. They are administered in the mid to low lumbar regions, primarily acting on the cauda equina's nerve roots. The blockade level depends on the local anesthetic (LA) concentration. Usually, low LA concentrations are sufficient to block sensory fibers, while only high LA concentrations block motor fibers. Other factors like injection volume and speed, the patient's posture, and the drug...
Anatomical Positions01:11

Anatomical Positions

In anatomy, several standard anatomical positions are used as references for describing the position and orientation of different body parts. These positions help provide a common frame of reference when discussing anatomical structures. The anatomical position is the standard reference point for describing the body's position and orientation. In this position:
The body is upright, facing forward, and standing erect.
The feet are parallel and flat on the floor.
The arms are hanging by the...
Local Anesthetics: Clinical Application as Epidural Anesthesia01:29

Local Anesthetics: Clinical Application as Epidural Anesthesia

Epidural anesthetics are administered in the fat-filled epidural space, the outermost part of the spinal canal. This technique is commonly employed for pain management and anesthesia during lower abdomen and pelvis surgeries or labor and delivery.
Since epidural anesthetics can be infused through an epidural catheter, all types of drugs, including short-acting ones, can be administered. Chloroprocaine and lidocaine are examples of short and long-duration anesthetics, respectively. Bupivacaine...

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Related Experiment Video

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Three-dimensional Navigation-guided, Prone, Single-position, Lateral Lumbar Interbody Fusion Technique
08:38

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Induction position for spinal anaesthesia: sitting versus lateral position.

Khurrum Shahzad1, Gauhar Afshan

  • 1Department of Anaesthesia, Aga Khan University Hospital, Karachi, Pakistan.

JPMA. the Journal of the Pakistan Medical Association
|July 20, 2013
PubMed
Summary
This summary is machine-generated.

For elderly patients receiving spinal anesthesia with isobaric bupivacaine, both sitting and lateral positions provide similar block characteristics and hemodynamic stability. However, the lateral position is generally more comfortable for patients during induction.

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Area of Science:

  • Anesthesiology
  • Geriatric Medicine
  • Neurosurgery

Background:

  • Spinal anesthesia is commonly used in elderly patients.
  • The choice of patient positioning during spinal anesthesia induction can influence block characteristics and patient comfort.
  • Isobaric bupivacaine is a frequently used local anesthetic for spinal anesthesia.

Purpose of the Study:

  • To compare the effects of sitting versus lateral positions on sensory and motor block characteristics.
  • To evaluate the impact of induction position on hemodynamic stability in elderly patients undergoing spinal anesthesia.
  • To assess patient comfort associated with different induction positions.

Main Methods:

  • A randomized, single-blinded study involving 70 elderly patients (>60 years).
  • Spinal anesthesia was administered in either a sitting or lateral position based on random allocation.
  • Sensory and motor block levels, heart rate, and blood pressure were monitored for 20 minutes post-induction.

Main Results:

  • No significant differences were observed in hemodynamic variables (heart rate, blood pressure) between the groups.
  • Anesthesia onset was faster in the sitting position (4.5 minutes) compared to the lateral position (5.4 minutes).
  • Motor block characteristics were comparable, but the lateral position was reported as more comfortable by the majority of patients.

Conclusions:

  • Both sitting and lateral positions are equally effective for achieving sensory and motor blockade and maintaining hemodynamic stability in elderly patients.
  • The lateral position offers superior patient comfort during the induction of spinal anesthesia.
  • These findings suggest that patient preference for comfort should be considered when selecting the induction position.