Turkish Journal of Anaesthesiology & Reanimation

Onset Time of Spinal Anaesthesia in Pregnant Females in Knee Chest Position: A Randomized Controlled Study


Department of Anaesthesiology, Pain Medicine and Critical Care, All India Institute of Medical Sciences, New Delhi, India

Turk J Anaesthesiol Reanim 1; 1: -
DOI: 10.5152/TJAR.2021.919
Read: 79 Downloads: 73 Published: 01 June 2021

Objectives: To assess the efficacy of knee chest position (KCP) in shortening the time of spinal induction in pregnant women undergoing elective caesarean section. We also assessed for any untoward adverse events that might limit its usefulness in real life clinical scenarios.

Methods: Prospective, randomized controlled study done in maternity operating room of tertiary care institution in 45ASA II pregnant women undergoing elective caesarean section under spinal anaesthesia. Patients were randomly assigned to Group S (supine) and K (KCP). After performing subarachnoid block (9 mg of 0.5% hyperbaric bupivacaine and 25μg fentanyl) in the sitting position, women in Group K were maintained in the KCP for 60 seconds. Time to attain block height of T6 and maximum sensory blockade, intraoperative haemodynamics, Bromage score, intraoperative fluid and vasopressor requirement and respiratory parameters were recorded. The newborn was evaluated using APGAR scores at 1 and 5 minutes.

Results: Data of 45 patients was analyzed. Time to attainT6 block height (group K=2.1±0.65 minutes, 95% CI: 1.83-2.39 min; group S=6.4±0.77 min, CI: 6.10-6.78min) and time to achieve maximum sensory block height were significantly lower in Group K (group K=3.2±1.35min, CI: 2.61-3.78; group S=6.6±0.89 min, CI: 6.19- 6.98). Degree of motor block was higher in group K than that of group S at 2minutes (p=0.0002), 4minutes (p<0.0001) and 6minutes (p<0.0001), with no difference at 8 minutes. No statistically significant difference was observed in fluids and vasopressors requirement intraoperatively.

Conclusion: This study provides evidence that the onset of adequate surgical anaesthesia for caesarean section can be hastened by placing the patient in KCP for a minute after performing subarachnoid block in the sitting position.

Cite this article as: Narasimhan P, Garg H, Maitra S, et al. Onset Time of Spinal Anaesthesia in Pregnant Females in Knee Chest Position: A Randomized Controlled Study. Turk J Anaesthesiol Reanim. 2021; doi: 10.5152/TJAR.2021.1422

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