Use of Squatting Position for Facilitating of Spinal Block Performance in Patients undergoing Cesarean Delivery

Abstract

Selecting the appropriate position during induction of spinal anesthesia for pregnant women and anesthetists is necessary to avoid incomplete and unsuccessful spinal anesthesia. Sitting position is commonly used for spinal anesthesia. In the sitting position, reduction of lumbar lordosis is essential for easier access to the space between the vertebrae and the dorsum. Squatting position has been introduced to increase the space between the vertebrae. The aim of this study was to use a squat sitting position to facilitate spinal block in patients undergoing cesarean section and compare it with the classic sitting position. Materials and Methods: In this double-blind randomized clinical trial, 120 full-term and single twin pregnant women aged 18-40 years with I or II classification of American Anesthesiologists (ASA) underwent cesarean section with spinal anesthesia. Were. Patients in the study group (60 cases) sat in a squatting position and patients in the control group (60 cases) in a standard sitting position underwent spinal anesthesia. The frequency of success and other spinal anesthesia variables were evaluated and compared in the two study groups. Results: The frequency of successful spinal anesthesia in the first attempt in the study group (91.67%) was significantly higher than the control group (78.34%) (p=0.034). Mean difficulty score of vertebral landmarks (1.20±0.97 vs. 1.80±1.07; p=0.002), mean number of needle-bone contact (1.48±1.34vs. 2.45±1.74; p=0.001), mean score of the spinal anesthesia (1.91±1.76 vs. 3.11±10.2; p=0.001) in patients of the study group was significantly lesser than control group. The frequency of easy degree of ease (difficulty) of spinal anesthesia in patients in the study group was significantly higher than patients in the control group (50% vs. 26.67%; p=0.009).