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Research Article
 

The Influence of Lateral Decubitus Position in Patients Receiving Unilateral Spinal Anesthesia on the Sensory Block, Motoric Block and Hemodynamic Stability in Lower Limb Surgery



Syafri Kamsul Arif and Firmansyah
 
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ABSTRACT

Unilateral spinal anesthesia is used to limit sympathetic, sensory and motor blocks and minimize hemodynamic changes. This study aimed to assess the effect of unilateral spinal anesthesia on patients with lower limb surgery when they were kept in the lateral decubitus position for 10, 15 and 20 min. We observed the effect of hyperbaric bupivacaine (0.5% of 10 mg) on sensory block, motor block and hemodynamic stability. This single-blind, randomized clinical trial was conducted on 51 subjects divided into 3 groups (each consisted of 17 subjects). Each group received spinal anesthesia (with the surgery side down) using hyperbaric bupivacaine (0.5% of 10 mg). Bevel was directed toward the surgery side and the injection was given slowly over 60 seconds without barbotage. After administration of spinal anesthesia, the lateral decubitus position was maintained for 10 min in group A, 15 min in group B and 20 min in group C. After that, patients returned to the supine position and block onset, duration and height and the patients’ hemodynamics were assessed. The findings of this research revealed that there was no significant difference in the onset of sensory and motor blocks, nor on the height of the sensory and motor blocks on the surgery side (p<0.05). The height of the sensory block on the independent side was Th12 (group A), L3 (group B) and S1 (group C). The duration of the sensory block on the independent side was 71.47±10.4 min (group A), 63.53±4.9 minutes (group B) and 50.59±13.4 min (group C). This showed significant difference (p<0.05). The duration of the motor block on the independent side was 109.41±18.2 min (group A), 84.71±33.9 min (group B) and 7.06±19.9 min (group C). This also showed a significant difference (p<0.05). Unilateral motor block was 88.2% in group C and 11.8% in group B; however, it was not achieved in group A. The three groups showed hemodynamic stability in mean arterial pressure and heart rate. Lateral decubitus position lasting 10, 15 and 20 min after unilateral spinal anesthesia had different influences on sensory and motor blocks on the independent side.

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  How to cite this article:

Syafri Kamsul Arif and Firmansyah , 2016. The Influence of Lateral Decubitus Position in Patients Receiving Unilateral Spinal Anesthesia on the Sensory Block, Motoric Block and Hemodynamic Stability in Lower Limb Surgery. Pakistan Journal of Nutrition, 15: 474-479.

DOI: 10.3923/pjn.2016.474.479

URL: https://scialert.net/abstract/?doi=pjn.2016.474.479

REFERENCES
1:  Atef, H.M., A.M. El-Kasaby, M.A. Omera and M.D. Badr, 2010. Optimal dose of hyperbaric bupivacaine 0.5% for unilateral spinal anesthesia during diagnostic knee arthroscopy. Local Reg. Anesth., 3: 85-91.
CrossRef  |  Direct Link  |  

2:  Borghi, B. and I. Bacchilega, 2014. Unilateral spinal anaesthesia. Diaska, January 2015. http://anestit.unipa.it/sitosiaarti/3aneortoped/24.htm.

3:  Casati, A., E. Moizo, C. Marchetti, F. Vinciguerra and M.D. Federico, 2004. A prospective, randomized, double-blind comparison of unilateral spinal anesthesia with hyperbaric bupivacaine, ropivacaine, or levobupivacaine for inguinal herniorrhaphy. Anesth. Analg., 99: 1387-1392.
Direct Link  |  

4:  Ijaz, N., K. Ali, F. Afsal and S. Ahmad, 2013. Comparison of haemodynamic effects of unilateral versus bilateral spinal anaesthesia in adult patients undergoing inguinal hernia repair. Biomedica, 29: 244-250.
Direct Link  |  

5:  Kim, J.T., J.H. Lee, C.W. Cho, H.C. Kim and J.H. Bahk, 2013. The influence of spinal flexion in the lateral decubitus position on the unilaterality of spinal anesthesia. Anesth. Analg., 117: 1017-1021.
CrossRef  |  Direct Link  |  

6:  Kirdemir, P., A. Marsan and V. Kirdemir, 2006. Comparison of hemodynamic and postoperative analgesic effects and recovery of unilateral and bilateral spinal anesthesia. Neuroscience, 2: 37-40.
Direct Link  |  

7:  Martin-Salvaj, G., E. Van Gessel, A. Forster, A. Schweizer, I. Iselin-Chaves and Z. Gamulin, 1994. Influence of duration of lateral decubitus on the spread of hyperbaric tetracaine during spinal anesthesia: A prospective time-response study. Anesth. Anal., 79: 1107-1112.
PubMed  |  Direct Link  |  

8:  Mirea, L., R. Ungureanu, R. Burtea, D. Pavelescu and I. Grintescu, 2012. Effect of injection speed on hypotension associated with spinal anesthesia for orthopedic surgery in elderly patients: 8AP3‐6. Eur. J. Anaesth., 29: 123-123.
Direct Link  |  

9:  Scavone, B.M., J. Ratliff and C.A. Wong, 2007. Physiologic Effects of Neuraxial Anesthesia. In: Spinal and Epidural Anesthesia, Wong, C.A. (Ed.). McGraw-Hill, New York, ISBN-13: 9780071437721, pp: 111-126.

10:  Singh, T.K., A. Anabarsan, U. Srivastava, A. Kannaujia, A. Gupta, C.P. Pal and V. Chandra, 2014. Unilateral spinal anaesthesia for lower limb orthopaedic surgery using low dose bupivacaine with fentanyl or clonidine: A randomised control study. J. Anesth. Clin. Res., 5: 1-5.
Direct Link  |  

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