Anesthesia, Conduction
Conditions
Keywords
neuraxial anesthesia positioning technique, Anatolian sitting position, sitting cross-legged position, sitting fetal position, ultrasonography, numerical rating scale
Brief summary
A prosperous neuraxial anesthesia positioning ensures a raised chance of successful needle placement. The primary aim is to compare The Anatolian sitting position-ASP with The Sitting Fetal Position-SFP sonographically. Secondary aim is to compare their comfort.
Detailed description
Fifty participants were included to this prospective, randomized, consecutive controlled clinical study. Six parameters were evaluated in each position; subcutaneous tissue (ST), skin to spinous process (S-SP), transverse diameters of bilateral paraspinal muscles (left paraspinal muscle \[LPM\] and right paraspinal muscle \[RPM\]), interspinous gap opening (ISGO), mean of bilateral paraspinal muscles (MPM). The change of every measurement recorded via ultrasonography (USG) according to the positioning techniques (the Anatolian Sitting Position \[ASP\] could also be named as sitting fetal cross-legged position and the Sitting Fetal Position \[SFP\] which is a traditional sitting position) were also calculated. The calculations are explained briefly in primary outcomes (including the change of ASP-SFP in ST, S-SP, LPM, RPM, MPM, ISGO). Stretcher comfort (SC), position comfort (PC), lumbar comfort (LC), and abdominal comfort (AC) were evaluated by the participants with the 5-point Numerical Rating Scale (NRS).
Interventions
PROCEDUREThe SFP technique
The USG, and the 5-point NRS evaluation in the SFP
PROCEDUREThe ASP technique
The USG, and the 5-point NRS evaluation in the ASP
Sponsors
Yeditepe University
Study design
Allocation
RANDOMIZED
Intervention model
SEQUENTIAL
Primary purpose
OTHER
Masking
SINGLE (Outcomes Assessor)
Masking description
The ultrasonography was made by a consultant radiologist (M.D.) Although the consultant didn't know which position was for control and which was the one the study evaluates. Although investigators were trying to mask the outcomes assessor; the consultant saw the positions because there is no way to hide the sitting positions of the participants. So there is a paradox if the consultant is masked or not.
Intervention model description
Systematic randomization was made from 150 volunteers, and 50 participants were chosen. All 50 participants were planned to sit on the stretcher in both of the two positioning techniques sequentially (one after another). The two positioning techniques are 1) sitting fetal position- the SFP ( a traditional position ) and 2) sitting fetal cross-legged- the ASP ( a new position, named as Anatolian sitting position). The investigator was planned to record all of the participants' anatomical measurements in both of those positioning techniques evaluated via ultrasonography. After each position participants were planned to evaluate each positioning technique's comfort by 5-point numerical rating scale from minimum 1 meaning poor to maximum 5 meaning excellent.
Eligibility
Sex/Gender
ALL
Age
18 Years to 45 Years
Healthy volunteers
Yes
Inclusion criteria
* healty and adult volunteers, * must be able to do the sitting fetal cross-legged position ( ASP ), * must be able to do the sitting fetal position ( SFP ).
Exclusion criteria
* BMI higher than 40, * Lumbar hernia, * Scoliosis, * History of spine surgery, * History of trauma, * History of lower back pain, * Arthropathy {especially pelvic or knee problems}, * Could not be able to do one or both of the two neuraxial position techniques.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| the change of S-SP (S-SP ASP-SFP) | S-SP in the ASP is measured in between 50mins. and 1hr. time, and S-SP in the SFP is measured in between 2 hrs. and 2hrs.10mins. time, through study completion. | Measured by calculation (\[S-SP in ASP in millimeters\]-\[S-SP in SFP in millimeters\]) |
| the change of MPM (MPM ASP-SFP) | MPM in the ASP is measured in between 30mins. and 40mins. time, and MPM in the SFP is measured in between 1hr.40mins and 1hr.50mins. time, through study completion. | Measured by calculation (\[MPM in ASP in millimeters\]-\[MPM in SFP in millimeters\]) |
| the change of ST (ST ASP-SFP) | ST in the ASP is measured in between 40mins. and 50mins. time, and in the SFP is measured in between 1hr.50mins and 2hrs. time, through study completion. | Measured by calculation (\[ST in ASP in millimeters\]-\[ST in SFP in millimeters\]) |
| Interspinous gap opening (ISGO) measurement in the ASP | For the ASP technique, ISGO is measured in the first 10 minutes(mins.) time, for each participant, through study completion. | the wideness measurement of the ISGO in millimeters via ultrasonography (USG) in the ASP |
| Left paraspinal muscle (LPM) measurements in the ASP | For the ASP technique, LPM is measured in between 10mins. and 20mins. time, for each participant, through study completion. | the diameter measurement of the LPM in millimeters via ultrasonography in the ASP |
| Right paraspinal muscle (RPM) measurements in the ASP | For the ASP technique, RPM is measured in between 20mins. and 30mins. time, for each participant, through study completion. | the diameter measurement of the RPM in millimeters via ultrasonography in the ASP |
| The mean of bilateral paraspinal muscles (MPM) in the ASP | For the ASP technique, MPM measurement is planned to be done in between 30mins. and 40mins. time, for each participant, through study completion. | Measured by ( \[LPM+RPM\]/2) in millimeters in the ASP |
| Subcutaneous tissue (ST) measurements in the ASP | For the ASP technique, ST measurement is planned to be done in between 40mins. and 50mins. time, for each participant, through study completion. | the thickness measurement of the subcutaneous tissue in millimeters via ultrasonography in the ASP |
| The skin to spinous process (S-SP) measurements in the ASP | For the ASP technique, S-SP measurement is planned to be done in between 50mins. and 1 hour(hr.) time, for each participant, through study completion. | the depth measurement of the skin to spinous process in millimeters via ultrasonography in the ASP |
| Interspinous gap opening (ISGO) measurement in the SFP | For the SFP technique, ISGO measurement is planned to be done, right after NRS evaluation of the ASP, in between 1hr.10mins. and 1hr.20mins. time, for each participant, through study completion. | the wideness measurement of the ISGO in millimeters via ultrasonography in the SFP |
| Left paraspinal muscle (LPM) measurements in the SFP | For the SFP technique, LPM measurement is planned to be done in between 1hr.20mins. and 1hr.30mins. time, for each participant, through study completion. | the diameter measurement of the LPM in millimeters via ultrasonography in the SFP |
| Right paraspinal muscle (RPM) measurements in the SFP | For the SFP technique, RPM measurement is planned to be done in between 1hr.30mins. and 1hr.40mins. time, for each participant, through study completion. | the diameter measurement of the RPM in millimeters via ultrasonography in the SFP |
| The mean of bilateral paraspinal muscles (MPM) in the SFP | For the SFP technique, MPM measurement is planned to be done in between 1hr.40mins. and 1hr.50mins. time, for each participant, through study completion. | Measured by ( \[LPM+RPM\]/2) in millimeters in the SFP |
| Subcutaneous tissue (ST) measurements in the SFP | For the SFP technique, ST measurement is planned to be done in between 1hr.50mins. and 2hrs. time, for each participant, through study completion. | the thickness measurement of the subcutaneous tissue in millimeters via ultrasonography in the SFP |
| The skin to spinous process (S-SP) measurements in the SFP | For the SFP technique, S-SP measurement is planned to be done in between 2hrs. and 2hr.10mins. time, for each participant, through study completion. | the depth measurement of the skin to spinous process in millimeters via ultrasonography in the SFP |
| the change of ISGO (ISGO ASP-SFP) | ISGO in the ASP is measured in the first 10mins., and ISGO in the SFP is measured in between 1hr.10 mins. and 1hr.20mins. time, through study completion. | Measured by calculation; (\[ISGO in the ASP in millimeters\]-\[ISGO in the SFP in millimeters\]) |
| the change of LPM (LPM ASP-SFP) | LPM in the ASP is measured in between 10mins. and 20mins. time, and LPM in the SFP is measured in between 1hr.20mins and 1hr.30mins. time, through study completion. | Measured by calculation; (\[LPM in ASP in millimeters\]-\[LPM in SFP in millimeters\]) |
| the change of RPM (RPM ASP-SFP) | RPM in the ASP is measured in between 20mins. and 30mins. time, and RPM in the SFP is measured in between 1hr.30mins. and 1hr.40mins. time, through study completion. | Measured by calculation (\[RPM in ASP in millimeters\]-\[RPM in SFP in millimeters\]) |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Comfort evaluation in the SFP via 5-point numerical rating scale (NRS) | NRS measurement is planned to be done right after the SFP position in between 2hrs.10mins. and 2hrs.20mins. time, for each participant, through study completion. | Comfort evaluation of the SFP technique is planned to be done by the participant right after USG. The 5-point NRS includes 5 scale. The minimum scale is1 means poor, 2 means fair, 3 means good, 4 means very good, and the maximum scale is 5 means excellent. |
| Comfort evaluation in the ASP via 5-point numerical rating scale (NRS) | NRS measurement is planned to be done right after the ASP position in between 1hr. and 1hr.10mins. time, for each participant, through study completion. | Comfort evaluation of the ASP technique is planned to be done by the participant right after USG. The 5-point NRS includes 5 scale. The minimum scale is1 means poor, 2 means fair, 3 means good, 4 means very good, and the maximum scale is 5 means excellent. |
Countries
Turkey (Türkiye)
Outcome results
None listed