Comparison of Level of Block Achieved after Spinal Anesthesia in Over Weight and Non-Over Weight Patient Undergoing Surgery below Umbilicus at Selected Public Hospitals in Addis Ababa
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Date
2025-06-28
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Addis Ababa University
Abstract
Background: Obesity and its influence on Spinal anesthesia is a significant factors for surgeries
below an umbilicus associated with effective level of sensory and motor block, As well as it has
been a significant effect on the cephalic spread of a spinal block (SB) due to a reduction in
cerebrospinal fluid (CSF).
Objective: To compare level of block achieved after spinal anesthesia in over weight and non over
weight patients undergoing surgery below umbilicus at selected Public hospitals in western shewa,
Oromia, Ethiopia.
Methods: This study divided 140 patients who had surgery below the umbilicus into two groups: 70
patients who were overweight and 70 patients who were not. A level of sensory and motor assessed
by A bilateral T12-T4 and bromage scale 0,1,2,3, respectively within induction phase(5minuts),10
minutes and at the end of surgery of the intrathecal medication injection was deemed to indicate an
effectiveness level of spinal block for lower umbilicus surgery under spinal anesthesia. Using
numerous variables that independently affect the spinal anesthesia outcome, logistic regression was
used to assess the parameters that affect the procedure..
Results: On multivariate analysis, overweight’s were had higher sensory and complete motor block.
AOR:1.95CI(1.5-2.5),p:<0.001,andAOR:1.5,CI:(1.2-1.87),p:<0.001respectively in contrast to their
counterparts and dose of bupivacaine also were significantly associated to higher motor and sensory
blocks. Additionally, the dose of bupivacaine (AOR:1.56(CI: 1.24-1-2.3), P:0.028) were independent
predictors of effective anesthesia in the patients where as BMI kg/m2 was found to be a predictor of
effective level of block under spinal anesthesia by multivariate analysis (odds ratio at 95% CI: 1.25;
1.1-1.4, p: 0.001). Moreover, the multivariate analysis's findings also showed that overweight, body
mass index (BMI), and level of spinal block were predictors of spinal anesthesia. Additionally, it
was discovered that the over weight group experienced bupivacaine-induced sensory and motor
blocking level than the non-over weight group.
Conclusion:. These findings imply that overweight people had a high level of sensory and motor
block, than non-over weight patients. Additionally, BMI, and bupivacaine dosage are significant
predictors of level of spinal block under spinal anesthesia.
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Keywords
Spinal anesthesia, Bupivacaine, Obesity, Body mass index, Ethiopia