COMPARISON OF SUBARACHNOID BLOCK INDUCTION IN TRADITIONAL SITTING POSITION AND CROSSED LEG POSITION FOR CAESAREAN SECTION: A RANDOMIZED CONTROLLED TRIAL

Background and Aims:The position of the patient during spinal anaesthesia has a role in its success.Landmarks of the spine can be easily identified in sitting position.The traditional sitting position (TSP) and crossed leg sitting position (CLSP) are positions used for neuraxial anaesthesia.In this study, we compared the ease of performing subarachnoid blocks in these two positions.The objectives were to compare the attempts at subarachnoid placement of the spinal needle, patient comfort, ease of landmark palpation.

Methods:This randomized trial was performed in 80 parturients posted forcesarean section. Parturients were assigned randomly to two groups. In group TSP, the subarachnoid block was performed in sitting position with legs side by side hanging by the side of the bed with feet propped up on a chair and hugging a pillow and in group CLSP with knees and hips flexed and hugging a pillow.

Results:The percentage of parturients with a successful subarachnoid block in the first attempt was higher in the CLSP than in TSP group (87.5% versus 55%). The remaining 12.5% parturients in the CLSP group had successful block in the second attempt. In the TSP group, 32.5% required two attempts and 12.5% required more than two attempts. This difference was statistically significant (P-value of 0.003). The landmark was easily palpable in 92.5 versus 67.5% of parturients in CLSP and TSP, respectively, with a P-value of 0.014.

Conclusion: CLSP is better than the traditional sitting position for reducing the number of attempts and improving the ease of performing the subarachnoid blockin a parturient.