Lumbar Puncture, Patient Positioning, Spinal Anesthesia
Conditions
Keywords
Imran Technique, Spinal Anesthesia, Lumbar Puncture, Patient Positioning, Ergonomics, Procedural Success, Anesthesia Technique
Brief summary
This quasi-experimental prospective clinical trial was conducted to compare the conventional sitting position with the Imran Technique, a novel ergonomic patient-positioning method, for spinal anesthesia and lumbar puncture. A total of 200 adult participants requiring spinal anesthesia for surgical procedures or diagnostic lumbar puncture were allocated into two groups. The study aimed to evaluate procedural success, procedural efficiency, patient comfort, operator ergonomics, and procedure-related complications associated with the two positioning techniques.
Detailed description
This quasi-experimental prospective clinical trial was designed to compare the conventional sitting position and the Imran Technique during spinal anesthesia and lumbar puncture procedures. Adult participants aged 18 to 65 years who required spinal anesthesia for surgical procedures or diagnostic lumbar puncture were enrolled and allocated into two groups. Participants in the control group underwent the procedure using the conventional sitting position, while participants in the intervention group underwent the procedure using the Imran Technique. The primary outcome measure was first-attempt procedural success. Secondary outcome measures included total procedural time, positioning-to-needle insertion time, number of needle attempts, needle redirections, intervertebral space changes, overall procedural success, need for operator assistance, patient comfort, ability to maintain position, operator strain, accessibility of the intervertebral space, and procedure-related complications. The study was conducted at the Intensive Care Unit of the Department of Anaesthesiology, POF Hospital, Wah Cantt, Pakistan, following Institutional Review Board approval and written informed consent procedures.
Interventions
PROCEDUREConventional Sitting Position
Standard sitting patient positioning used for spinal anesthesia and lumbar puncture procedures.
PROCEDUREImran Technique
A novel ergonomic patient positioning technique for spinal anesthesia and lumbar puncture involving lateral operator positioning and assisted lumbar flexion to improve procedural access and success.
Sponsors
Wah Medical college , POF hospital
Study design
Allocation
NON_RANDOMIZED
Intervention model
PARALLEL
Primary purpose
OTHER
Masking
NONE
Intervention model description
Participants were allocated into two parallel groups to compare the conventional sitting position with the Imran Technique for spinal anesthesia and lumbar puncture.
Eligibility
Sex/Gender
ALL
Age
18 Years to 65 Years
Healthy volunteers
No
Inclusion criteria
* Adult participants aged 18 to 65 years * Participants requiring spinal anesthesia for surgical procedures or diagnostic lumbar puncture * Participants medically suitable for spinal anesthesia or lumbar puncture * Participants able to assume and maintain the assigned procedural position * Participants who provided written informed consent
Exclusion criteria
* Age below 18 years or above 65 years * Previous spinal surgery * Significant spinal deformity * Local infection at the puncture site * Coagulopathy or bleeding disorders * Raised intracranial pressure * Severe hemodynamic instability * Inability to maintain the assigned procedural position * Refusal to participate or inability to provide informed consent
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| First Attempt Procedural Success | During the procedure (up to 30 minutes) | Successful spinal anesthesia or lumbar puncture achieved with a single skin puncture on the first attempt. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Total Procedural Time | During the procedure (up to 30 minutes) | Total time required from patient positioning to successful completion of spinal anesthesia or lumbar puncture. |
| Number of Needle Attempts | During the procedure | Total number of skin puncture attempts required to successfully complete the procedure. |
| Needle Redirections | During the procedure | Number of needle redirections required during spinal anesthesia or lumbar puncture. |
| Intervertebral Space Changes | During the procedure | Number of intervertebral space changes required to successfully complete the procedure. |
| Overall Procedural Success | During the procedure (up to 30 minutes) | Successful completion of spinal anesthesia or lumbar puncture regardless of the number of attempts required. |
| Patient Comfort Assessed Using a 0-10 Numeric Rating Scale (NRS) | During the procedure | Participant comfort during positioning and spinal anesthesia/lumbar puncture was assessed using a 0-10 Numeric Rating Scale, where lower scores indicate greater comfort. |
| Ability to Maintain Position Assessed Using an Investigator-Defined 3-Category Scale | During the procedure | Participant ability to maintain the assigned procedural position was assessed using an investigator-defined 3-category scale: Easy, Moderate, or Difficult. |
| Operator Strain Assessed Using an Investigator-Defined 4-Category Ergonomic Scale | During the procedure | Operator physical strain during the procedure was assessed using an investigator-defined 4-category scale: None, Mild, Moderate, or Severe. |
| Accessibility of Intervertebral Space Assessed Using an Investigator-Defined 3-Category Operator Rating Scale | During the procedure | Accessibility of the intervertebral space was assessed by the operator using an investigator-defined 3-category scale: Easy, Acceptable, or Difficult. |
| Procedure-Related Complications | uring the procedure and immediately after procedure (up to 1 hour) | Occurrence of procedure-related events including paresthesia, bloody tap, hypotension, bradycardia, or procedural failure. |
Countries
Pakistan
Contacts
PRINCIPAL_INVESTIGATORImran Ul Haq, MBBS, FCPS
Wah Medical College (NUMS) / POF Hospital Wah Cantt, Pakistan
Outcome results
None listed