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http://dx.doi.org/10.7586/jkbns.2015.17.2.114

Comparison of the Level and Side Effects of Spinal Anesthesia with Hyperbaric Bupivacaine in the Supine, Lateral, and Prone Positions  

Moon, Ji Young (Graduate School of Nursing, Gachon University)
Kim, Bo Hwan (College of Nursing, Gachon University)
Publication Information
Journal of Korean Biological Nursing Science / v.17, no.2, 2015 , pp. 114-122 More about this Journal
Abstract
Purpose: This study attempted to test whether there are differences in the level and hemodynamic side effects (blood pressure, heart rate, $O_2$ saturation), and nausea & vomiting of spinal anesthesia using hyperbaric bupivacaine according to position (supine, lateral, and prone positions) in orthopedic surgery patients who received podiatric surgery under spinal anesthesia. Methods: This study was conducted with 53 patients who had received orthopedic surgery under spinal anesthesia at I General Hospital. Data were analyzed using SPSS 20.0 through repeated-measures ANOVA, post-hoc test, Chi-test, and Fisher's exact test. Results: The change of position after spinal anesthesia with hyperbaric bupivacaine caused a change in the level of spinal anesthesia (F=12.768, p<.001). However, no difference of blood pressure, heart rate, $O_2$ saturation and nausea and vomiting caused by the change in anesthesia level was observed, and in prone position, drug was administered for the correction of side effects. Conclusion: As expected, recognizing that there can be a change in the level of spinal anesthesia after the change of position in surgical patients, nurse anesthetists should monitor their conditions carefully and continuously.
Keywords
Hyperbaric bupivacaine; Spinal anesthesia; Position change; Anesthesia level; Side effects;
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Times Cited By KSCI : 5  (Citation Analysis)
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1 Ilies C, Ludwigs J, Gruenewald M, Thee C, Hanf J, Hanss R, et al. The effect of posture and anaesthetic technique on the surgical pleth index. Anaesthesia. 2012;67(5):508-513. http://dx.doi.org/10.1111/j.1365-2044.2011.07051.x   DOI   ScienceOn
2 Song HY, Choi JW, Kwon JD. The effect of positional change during laparoscopic surgery on intraocular pressure. Journal of The Korean Ophthalmological Society. 2011;52(10):1208-1214. http://dx.doi.org/10.3341/jkos.2011.52.10.1208   DOI
3 Jang M, Lee Y, Jeong S, Min K, Kim J, Kim G, et al. The effect of suitable positional care to the pain relating to the surgical position after surgery - focus on mastoidectomy patients. Journal of Korean Clinical Nursing Research. 2000;6(1):129-145.
4 Liu SS, McDonald SB. Current issues in spinal anesthesia. Anesthesiology. 2001;94(5):888-906. http://dx.doi.org/10.1097/00000542-200105000-00030   DOI   ScienceOn
5 Yoon KB. Spinal, epidural anesthesia and nerve blocks. In: The Korean Society of Anesthesiologists, editor. Anesthesiology and pain medicine. 2nd ed. Seoul: Ryo Moon Gak; 2010. p. 269-284.
6 Povey HM, Jacobsen J, Westergaard-Nielsen J. Subarachnoid analgesia with hyperbaric 0.5% bupivacaine: effect of a 60-min period of sitting. Acta Anaesthesiologica Scandinavica. 1989;33(4):295-297. http://dx.doi.org/10.1111/j.1399-6576.1989.tb02911.x   DOI   ScienceOn
7 Kim YS, Kim DK, Lee KC, Kang PS, Woo NS, Lee YC. Study of spinal sensory block height with 0.5% heavy bupivacaine in elderly patients. Korean Journal of Anesthesiology. 2003;44(4):488-493.   DOI
8 Suh Y, Kim Y, Choi H, Yoon H, Seo G, Lee B. Postoperative mortality and the associated factors in elderly patients with hip fracture. Journal of Korean Orthopaedic Association. 2012;47(6):445-451. http://dx.doi.org/10.4055/jkoa.2012.47.6.445   DOI
9 Yeah SH, Han JI, Lee CH. Anesthesia for lower extremity in the aged comparision of isobaric 0.5% bupivacaine and hyperbaric 0.5% bupivacaine. Korean Journal of Anesthesiology. 2000;38(2):314-321.   DOI
10 Greene NM. Distribution of local anesthetic solutions within the subarachnoid space. Anesthesia & Analgesia. 1985;64(7):715-730.
11 Brown DL. Spinal, epidural, and caudal anesthesia. In: Miller RD, editor. Anesthesia. 5th ed. San Francisco, California: Churchill Livingstone; 2000. p. 1491-1519.
12 Bernards CM. Epidural and spinal anesthesia. In: Barash PG, CullenBF, Stoelting RK, editors. Clinical anesthesia. 4th ed. Philadelphia: Lippincott Williams & Wilkins; 2001. p. 689-713.
13 Chang CH, Nam YT, Jeong JY, Choi SI, Lee Y. Comparative study of isobaric bupivacaine spinal anesthesia in the supine and prone positions. Korean Journal of Anesthesiology. 2003;44(5):605-611.   DOI
14 Kim BK, An DA. Influence of height and vertebral length on spinal anesthesia with 0.5% hyperbaric bupivacaine. Korean Journal of Anesthesiology. 1998;35(6):1089-1094.   DOI
15 Lee S, Oh SC, Yu S, Yoon K. A comparison of the incidence of hypotension during unilateral vs conventional spinal anesthesia with hyperbaric bupivacaine. Korean Journal of Anesthesiology. 2004;46(1):41-45.   DOI
16 Kang HK, Kim IS, Park SB, Hong SJ, Shin KM. The characteristics of clinical anesthesia based on the duration of lateral decubitus in low dose hyperbaric bupivacaine induced unilateral spinal block. Korean Journal of Anesthesiology. 2005;49(5):646-651.   DOI
17 Song SO, Koo BU. Spinal anesthesia for lower extremities: Comparison of plain 0.5% bupivacaine and hyperbaric 0.5% tetracaine. Yeungnam University Journal of Medicine. 1990;7(2):121-130.
18 Kim JY, Lee DW, Seo IS, Kim SY. Cardiovascular effects of free movement of abdominal muscle in prone positioning during general anesthesia. Yeungnam University Journal of Medicine. 2007;24(2):206-215.   DOI
19 Bai CS, Yoon HS. Comparison of job tasks and task elements of korean nurse anesthetists by type of medical institution: Hospital, general hospital and higher general hospital. The Journal of Korean Nursing Administration Academic Society. 2013;19(2):239-253. http://dx.doi.org/10.11111/.jkana.2013.19.2.239   DOI   ScienceOn
20 Veering BT, Immink-Speet TTM, Burm AGL, Stienstra R, van Kleef JW. Spinal anaesthesia with 0.5% hyperbaric bupivacaine in elderly patients: effects of duration spent in the sitting position. British Journal of Anaesthesia. 2001;87(5):738-742. http://dx.doi.org/10.1093/bja/87.5.738   DOI   ScienceOn
21 Shin Y. Variation in arterial to end-tidal carbon dioxide tension differences during general anesthesia in the prone position. Chungnam Medical Journal. 1993;20(2):405-410.
22 Cho SY, Noh GJ, Yeom JH, Shin WJ, Kim YC, Kim KH, et al. The effect of prone position on pulmonary compliances by anesthesia duration. Korean Journal of Anesthesiology. 2000;38(6):997-1001.   DOI
23 Gougoulias N, Dawe E, Sakellariou A. The recovery position for posterior surgery of the ankle and hindfoot. The Bone & Joint Journal. 2013;95-B(10):1317-1319. http://dx.doi.org/10.1302/0301-620X.95B10.32527   DOI   ScienceOn
24 Toyota S, Amaki Y. Hemodynamic evaluation of the prone position by transesophageal echocardiography. Journal of Clinical Anesthesia. 1998;10(1):32-35.   DOI   ScienceOn