Abstract
Background
Previous evidences suggested that traditional sitting position (flexion of knees approximately 90° and adduction of hips while feet rest on a stool) and lateral decubit position (sitting position with maximum extension of knees, adduction of hips, and forward bending) both reversed the lumbar lordosis and the number of spinal needle-bone contacts were identical when placing patients in these positions for neuraxial block.
Objectives
In this study, we suggested that abdominal crunch position reverses the lumbar lordosis and increase the gap of interspinal distance better than a traditional sitting position and lateral decubit position.
Patients and Methods
One hundred patients ASA (American Society of Anesthesiologist) class I or II aged over 18 years old scheduled for elective surgeries under elective spinal anesthesia. We compared the traditional sitting, lateral decubit position, and abdominal crunch position. Our primary endpoint was to detect the increasing of interspinal gap by ultrasound.
Results
The gap of interspinal distance was statistically higher in the abdominal crunch position compared to traditional sitting position and lateral decubit position (P = 0.01).
Conclusions
We suggested that the abdominal crunch position can to help our colleagues especially with the maximum spinal interval in the spinal anesthesia management.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Afolayan JM, Areo PO, Adegun PT, Ogundipe KO, Filani AB (2017) Comparison of ease of induction of spinal anaesthesia in sitting with legs parallel on the table versus traditional sitting position. Pan Afr Med J 28(1). https://doi.org/10.11604/pamj.2017.28.223.6992
Defloor T (2000) The effect of position and mattress on interface pressure. Appl Nurs Res 13(1):2–11
Manggala SK, Tantri AR, Satoto D (2016) Comparison of successful spinal needle placement between crossed-leg sitting position and traditional sitting position in patients undergoing urology surgery. Anesthesiol Pain Med 6(4):e39314
Mohammadi SS, Hassani M, Marashi SM (2014) Comparing the squatting position and traditional sitting position for ease of spinal needle placement: a randomized clinical trial. Anesthesiol Pain Med 4(2):e13969
Mohammadi SS, Piri M, Khajehnasiri A (2017) Comparing three different modified sitting positions for ease of spinal needle insertion in patients undergoing spinal anesthesia. AnesthesiolPain Med 7(5):e55932
Shankar H, Rajput K, Murugiah K (2012) Correlation between spinous process dimensions and ease of spinal anaesthesia. Indian J Anaesth 56(3):250
Petrofsky JS, Batt J, Davis N, Lohman E, Laymon M, De Leon GE et al (2007) Core muscle activity during exercise on a mini stability ball compared with abdominal crunches on the floor and on a swiss ball. J Appl Res Clin Exp Ther 7(3):255
Pierce SE (2017) Electromyographical comparison of the abdominal crunch to planks performed with and without a suspension trainer. California State University, Fresno
Handa N, Yamamoto H, Tani T, Kawakami T, Takemasa R (2000) The effect of trunk muscle exercises in patients over 40 years of age with chronic low back pain. J Orthop Sci 5(3):210–216
Ignasiak D, Rüeger A, Ferguson SJ (2017) Multi-segmental thoracic spine kinematics measured dynamically in the young and elderly during flexion. Hum Mov Sci 54:230–239
Butterworth J, Mackey D, Wasnick J (2013) Spinal, epidural, & caudal blocks. Morgan & Mikhail's clinical anesthesiology, 5th edn. McGraw-Hill, New York, pp 953–956
Martin-Salvaj G, Van EG, Forster A, Schweizer A, Iselin-Chaves I, Gamulin Z (1994) Influence of duration of lateral decubitus on the spread of hyperbaric tetracaine during spinal anesthesia: a prospective time-response study. Anesth Analg 79(6):1107–1112
McAfee PC, Eiserman L, Cunningham BW, Mullinix KA, Brooks DM (2017) Middle column gap balancing to predict optimal anterior structural support and spinal height in spinal reconstructive surgery. Spine. 42:S19–S20
Tessler MJ, Kardash K, Wahba RM, Kleiman SJ, Trihas ST, Rossignol M (1999) The performance of spinal anesthesia is marginally more difficult in the elderly. Reg Anesth Pain Med 24(2):126–130
Sprung J, Bourke DL, Grass J, Hammel J, Mascha E, Thomas P et al (1999) Predicting the difficult neuraxial block: a prospective study. Anesth Analg 89(2):384–389
Bagheri R, Takamjani IE, Dadgoo M, Ahmadi A, Sarrafzadeh J, Pourahmadi MR et al (2018) Gender-related differences in reliability of thorax, lumbar, and pelvis kinematics during gait in patients with non-specific chronic low back pain. Ann Rehabil Med 42(2):239
Biviá-Roig G, Lisón JF, Sánchez-Zuriaga D (2019) Effects of pregnancy on lumbar motion patterns and muscle responses. Spine J 19(2):364–371
Norris MC (1988) Height, weight, and the spread of subarachnoid hyperbaric bupivacaine in the term parturient. Anesth Analg 67(6):555–558
Siddiqui KM, Ali MA, Ullah H (2016) Comparison of spinal anesthesia dosage based on height and weight versus height alone in patients undergoing elective cesarean section. Korean J Anesthesiol 69(2):143
Pitkänen MT (1987) Body mass and spread of spinal anesthesia with bupivacaine. Anesth Analg 66(2):127–131
Author information
Authors and Affiliations
Corresponding author
Additional information
Publisher’s Note
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
Rights and permissions
About this article
Cite this article
Tire, Y., Mermer, A. & Kozanhan, B. Abdominal Crunch Position In Spinal Anesthesia: a Novel Sitting Position. Indian J Surg 83, 1481–1485 (2021). https://doi.org/10.1007/s12262-021-02744-y
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s12262-021-02744-y