Spinal anaesthesia for Caesarean section: effect of Sprotte needle orientation

• Published in: British Journal of Anaesthesia Vol. 77; no. 2; pp. 150 - 152
• Main Authors: James, K S, Stott, S M, McGrady, E M, Pearsall, F J, Frame, W T, Russell, D
• Format: Journal Article Conference Proceeding
• Language: English
• Published: Oxford Elsevier Ltd 01.08.1996; Oxford University Press; Oxford Publishing Limited (England)
• Subjects: Abdominal surgery. Urology. Gynecology. Obstetrics; Adult; Anesthesia; Anesthesia depending on type of surgery; Anesthesia, Obstetrical - methods; Anesthesia, Obstetrical - psychology; Anesthesia, Spinal - methods; Anesthesia, Spinal - psychology; Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy; Anesthetics, Local - administration & dosage; Anesthetics, Local - adverse effects; Biological and medical sciences; Bupivacaine - administration & dosage; Bupivacaine - adverse effects; Cesarean Section; Female; Humans; Hypotension - chemically induced; Medical sciences; Needles; Patient Satisfaction; Pregnancy; Thermosensing - drug effects; Time Factors; Human; Regional anesthesia; Surgery; Needle; Female; Technique; Orientation; Obstetrics; Intrathecal administration; Cesarean section
• ISSN: 0007-0912; 1471-6771
• DOI: 10.1093/bja/77.2.150

We induced spinal anaesthesia in 100 women presenting for elective Caesarean section with the mother in the right lateral position. Patients were allocated randomly to have the side eye of the 24-gauge Sprotte spinal needle pointing in one of four directions: group A, cephalad; group B, right lateral; group C, left lateral; group D, caudad. Isobaric bupivacaine 0.5% (2.5 ml) was injected over 30 s before the mother was placed supine with a 15 degree left lateral tilt. Onset time and height of the subsequent analgesic and anaesthetic blocks were assessed by a blinded observer. Onset of sensory block to T4 was significantly faster in group A (P = 0.001). There were no differences in final block height, incidence of hypotension, nausea and vomiting or ephedrine requirements.