The effect of anthropometric characteristics on the spread of hyperbaric bupivacaine spinal anaesthesia in patients undergoing lower abdominal or lower extremity surgery.

The effect of anthropometric characteristics on the spread of spinal anesthesia with 0.5% hyperbaric bupivacaine in patients undergoing lower abdominal or lower extremity surgery

Status

Completed

Phases

Phase 4

Study type

Interventional

Source

ANZCTR

Registry ID

ACTRN12616000479404

Enrollment

Registered

2016-04-12

Start date

2015-10-15

Completion date

2015-12-30

Last updated

2020-01-13

For informational purposes only — not medical advice. Sourced from public registries and may not reflect the latest updates. Terms

Conditions

None listed

Brief summary

Background:Several factors have been described to effect the spread of spinal anesthesia. Clinical sense says that patients with a larger hip size and a narrow shoulder size have a relative trendelenburg position on a horizontal operation table that results in more cephalad spread of the hyperbaric local anesthetic solution although there is no clinical study reporting the effect of hip/shoulder size ratio on the spread of spinal anesthesia.We hypothesized that the increase in cephalad spread is strongly correlated with the increased hip/shoulder size ratio. Methods: Age, weight, height, body mass index, hip size, shoulder size, hip/shoulder size ratio, vertebral column length were recorded for 75 patients. The L4-L5 interspace was introduced at lateral position on a horizontal operation table with a 25G spinal needle and 3ml 0.5% hyperbaric bupivacaine was injected intrathecal in 15 seconds without barbotage and patient was turned supine 5 minutes after intrathecal injection. Pearson and Sperman’sRho Correlation Tests were performed for the relation between age, height, weight, body mass index, hip size, hip/shoulder size ratio, shoulder size and vertebral column length and the multiple regression analysis was used to test the combined contribution of the above variables on cephalad spread of spinal anesthesia. Results:We determined a positive correlation with hip/shoulder size ratio (r = 0, 40; p = 0,002), and a negative correlation with the height (r= -0, 29; p=0,026), and the shoulder size (r= -0, 31; p= 0,017) of the patients with the cephalad spread ofspinal anesthesia. Multiple regression analysis showed that hip size and the hip/shoulder size ratio were the important determinants for the cephalad spread of spinal anesthesia and the other variables had no effect. Conclusions: The cephalad spread of spinal anesthesia with a fixed dose of hyperbaric bupivacaine is affected by the ratio of hip/shoulder size, shoulder size and the height of the patient. Vertebral column length has no effect on spinal anesthesia spread.

Interventions

3 ml 0.5% hyperebaric bupivacaine was injected intrathecally in 15 seconds wiithout barbotage as a single dose from L4-L5 interspace of spinal canal by an anesthesiologist. The dose administered was controlled by the study staff as a standard dose of 3ml according to study protocol. Surgery started when the level of spinal anesthesia reached to T10 dermatome

Study design

Allocation

Non-randomised trial

Intervention model

Single group

Primary purpose

Treatment

Masking

Open (masking not used)

Eligibility

Sex/Gender

All

Age

18 Years to 75 Years

Healthy volunteers

Inclusion criteria

patients approving spinal anesthesia and the study protocol for the surgery that he/she is undergoing( either lower extremity or lower abdominal surgery).

Exclusion criteria

patients refusing spinal anesthesia or the study protocol, any contraindication for spinal anesthesia, age greater than 75 years or smaller than 18 years

Outcome results