The effect of lateral versus sitting position during spinal anesthesia on postdural puncture headache and hemodynamic status among orthopedic patients in Black lion specialized, Addis Ababa, Ethiopia, 2023/24.
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Date
2024-06
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Addis Ababa University
Abstract
Background: Although spinal anesthesia is simple and creates a safe environment for surgeries
below umbilicus, it has many associated side effects that affect the quality of health system on
patients’ satisfaction. A postdural puncture headache is a common complication of spinal
anesthesia. Although orthopedic patients are among patients that take spinal anesthesia
repeatedly, studies that explain the association of postdural puncture headache with position
during administration of spinal anesthesia are limited.
Objectives: The objective of this study was to assess the effect of lateral vs. sitting position
during administration of spinal anesthesia on postdural puncture headache and hemodynamic
status among elective orthopedic patients.
Method: A prospective cohort study was conducted at Tikur Anbessa Specialized hospital, on
department of orthopedics and traumatology from January 1 to April 30, 2024. A total of 84
patients aged 20 to 66 with ASA class of I and II were selected by systematic random sampling
technique. The demographic data, intraoperative hemodynamics and other results were collected
and described in tables and figures. An independent samples t-test was used to analyze
hemodynamic status and a chi-square test was used to compare postdural puncture headache. A
statistical significance was determined when p value <0.05.
Result: The result of this study shows that incidence of postdural puncture headache among
elective orthopedic patients was 15.5% with 23% postdural puncture headache is from sitting
position and 7.3% from lateral position which is statistically significant with p value of .035.
Hypotension was significantly high in patients who have taken spinal anesthesia in lateral
position.
Conclusion and Recommendation: Our study demonstrated that the incidence of PDPH is low
when spinal anesthesia is administered in lateral position and also administration of spinal
anesthesia in lateral position decreased MAP which was a statistically significant. We
recommend anesthesia providers to make administering spinal anesthesia in lateral position to
patients with stable baseline blood pressure, part of routine activity in order to decrease an
incidence of a debilitating complication of SA called PDPH on this group of surgical patients.
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Keywords
Spinal anesthesia, postdural puncture headache, orthopedic patients, position