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Both hyperbaric and hypobaric ropivacaine (11.25mg) provided adequate and dependable anesthesia for total knee replacement surgery, with a high level of patient and surgeon comfort. Hypobaric local anesthetic solutions provide a high level of unilateral anesthesia, with rapid recovery of both sensory and motor block, and therefore may be preferable in outpatient settings.

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Introduction: Many factors have been tested to predict the spread of spinal anesthesia in clinical practice. In the study we aimed to investigate the correlation between hip/shoulder width ratio and spread of spinal anesthesia.Method: Sixty patients were enrolled in this study to determine the correlation between hip/shoulder width ratio and the spread of spinal anesthesia. The L4-L5 interspace, navigated by ultrasonography, was introduced at lateral position with a 25G spinal needle. 3ml 0,5% hyperbaric bupivacaine was injected intrathecal in 15 seconds. Age, height, weight, body mass index, hip/shoulder width ratio and vertebral column length were recorded. Spinal anesthesia spread was assessed at 0, 5, 10, 20, and 30 minutes after spinal anesthesia. Patient was turned supine 5 minutes after intrathecal injection. Multiple linear regression analysis was used to analyze correlation between the spread of spinal anesthesia and age, height, weight, hip/shoulder width ratio, vertebral column length.Results: The study was completed without dropout and sixty participants were included into analysis. There was a strong correlation between the spread of spinal anesthesia and hip/shoulder width ratio (r=0,766; p<0,0001) and a negative correlation with the height and vertebral column length (r= -0,572; -0,738 and p=0, 000; 0, 000 respectively).Conclusion: Cephalad spread of spinal anesthesia with a fixed dose of hyperbaric bupivacaine is strongly correlated with hip/shoulder width ratio and inversely correlated with height and vertebral column length. We may observe more spread with 0, 5% hyperbaric bupivacaine in patients with a greater hip/shoulder ratio and a shorter height.

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The success rate of endotracheal intubation decreases in paramedic students who used VL during endotracheal intubation education and had to use Macintosh laryngoscopes later. Therefore we believe that solely videolaryngoscopes is not enough in endotracheal intubation training programs.