spinal anesthesia elderly total knee arthroplasty total hip arthroplasty spinal anesthesia total knee arthroplasty total hip arthroplasty pre-
Conditions
Interventions
In group C (conventional),
the anesthesiologist palpated the landmarks after positioning and selected interspinous space at 3rd and 4th lumbar spines.
Strict aseptic technique was performed,
the anesthesiologist scrubbed before procedure,
wearing mask and sterile gloves.The skin was prepared by 2%chlorhexidine after with 1 to 2 ml of 1%lidocaine was use to infiltrate the skin(next to spinous process of 3rd lumbar spine 1 centimeter cau
G.Depth and angle of needle insertion depend on performed anesthesiologist. After CSF shown in spinal needle,
0.5% hyperbaric bupivacaine 3.0 ml was injected., In group P(pre-
procedural ultrasound guide),
a portable ultrasound unit (Sonosite M-
Tirbo,
Sonosite,
Washington) with curved 2-
5 MHz was used for initial pre-
prcedural marking. A paramedian sagittal oblique view was used to identify sacrum and subsequent interspinous spaces in a cranial direction,
interspinous spaces of 2nd-
3rd,
3rd-
4th and 4th-
5th .At interspinous space of 3rd and 4th lumbar spines,
depth from skin to posterior dura and anterior dura was measured and mark midpoint of both short and long border of the probe.Then use a transverse median view to measure depth from skin to posterior
Sponsors
none
Eligibility
Sex/Gender
All
Age
18 Years to No maximum
Inclusion criteria
Inclusion criteria: patient who was scheduled for total knee arthroplasty and total hip arthroplasty at King Chulalongkorn Memorial Hospital American Society of anesthesiologist (ASA) class 1 to 3 o ASA class 1 : A normal healthy patient ; non-smoking, no or minimal alcohol use o ASA class 2 : A patient with mild systemic disease ; Mild diseases only without substantive functional limitations. Examples include (but not limited to): current smoker, social alcohol drinker, pregnancy, obesity (30 3 months) of MI, CVA, TIA, or CAD/stents
Exclusion criteria
Exclusion criteria: refuse to participate this study allergy to any drug in this study contraindication to neuraxial anesthesia e.g. coagulopathy
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| A number of needle pass during procedure time(s) | — |
Secondary
| Measure | Time frame |
|---|---|
| A number of needle attempt during procedure time(s),Time to identify landmark for performing spinal anesthesia during procedure second(s),time from needle insertion to CSF flow through needle during procedure second(s),Pain score during procedure during procedure Numeric pain rating scale,Complication of spinal anesthesia post-operative post-dural puncture headache, paresthesia and spinal hematoma,Patient's satisfication during procedure Numeric rating scale | — |
Countries
Thailand
Contacts
Public ContactWireena Kampitak
Faculty of medicine, Chulalongkorn University
Outcome results
None listed