Abstract

A VISUAL AID IN ACHIEVING OPTIMAL POSITIONING FOR SPINAL ANESTHESIA: A RANDOMIZED TRIAL

Hussein Mustafa Thabet Al-Hadeethi* and Aimen Hameed Latef

ABSTRACT

Background: Patient positioning is considered as one of the important factors that determine the success of neuraxial anesthesia. The primary objective of this study is to evaluate the benefits of using a visual image in addition to verbal instructions in order to achieve an optimal spinal positioning. Patients and methods: This was a prospective randomized controlled trial on 80 adult patients underwent different types of below umbilicus surgery at The Medical City Tertiary Teaching Hospital (City, Iraq). Group 1 (n=40) received standardized verbal instructions while group 2 (n=40) received standardized verbal instruction with a visual image to obtain position for spinal anesthesia. The primary endpoint was to measure the time to successful lumbar puncture. Secondary endpoints included number of skin punctures, patients’ satisfaction score and anesthesiologist satisfaction score. Results: The mean time of CSF leak in group 1 receiving verbal instructions only (190.88 ± 89.17 sec.) was significantly longer than the time required for group 2 (132.48 ± 57.55 sec.) (P = 0.002). The number of spinal needle trials in group 1 (1.33 ± 0.57) was, significantly higher than in group 2 (1.18 ± 0.45) (P = 0.018). Additionally, the anesthesiologist satisfaction score also increased significantly (P = 0.043). Conclusion: The use of visual aid in addition to the verbal instructions shortened the time for a successful CSF leak with a better anesthesiologist’s satisfaction score.

Keywords: Anesthesia, Neuraxial block, Visual aid, Patient positioning.