The crossed-leg position increases the dimensions within the acoustic target window for neuraxial needle placement in term pregnancy: a prospective observational study

Sharma, Mouveen; Qasem, F.; Sebbag, Ilana; Jones, Philip M.; Singh, Sudha

doi:10.1016/j.ijoa.2020.08.011

Cited by 4 publications

(2 citation statements)

References 16 publications

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“…[ 9 ] Sharma et al . [ 10 ] showed mean interlaminar distance in cross-leg sitting position as 3.29(0.47) cm. The mean difference between the CSP and HSP was compared, and the sample size was calculated assuming power 90%, CI 95%, and 10% dropout rate.…”

Section: Methodsmentioning

confidence: 99%

Comparison of neuraxial acoustic target window of the spine among rider sitting, cross leg, hamstring stretch, and classical sitting position: An observational study

Singh,

Sethi,

Kaur

et al. 2024

Journal of Anaesthesiology Clinical Pharmacology

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Background and Aims: To compare ultra-sonographic dimensions of acoustic target window of the spine in the participants at four different sitting positions namely cross leg sitting (CLP), hamstring stretch (HSP), classical sitting (CSP) and riders sitting position (RSP). The primary objective of this study was to measure the neuraxial acoustic target window (defined as interlaminar distance between L3-L4 lamina). The secondary objective was to compare ultra-sonographic measurements of the depth of ligamentum flavum from the skin, and to compare the diameter of intrathecal space and comfort score in the four different sitting positions. Material and Methods: This study is a prospective observational study. Eighty participants were included and positioned in four different sitting positions to perform an ultra-sonographic scan and measure various parameters of the acoustic neuraxial window. The interlaminar distance, the distance of skin from the ligamentum flavum, and the diameter of the spinal canal or intrathecal space was measured in the L3-L4 intervertebral space in different positions. Results: The mean value of interlaminar distance among four sitting positions was ranging from 1.40 cm to 1.44 cm (P value 0.725.) The distance of ligamentum flavum from skin and diameter of intrathecal space was also comparable in all the groups. The comfort score in CSP was significantly better when compared to other groups with a median score of 4 (P value < 0.001). Conclusions: There is no statistically significant difference in interlaminar distance in various sitting positions. All four positions are equally effective and can be used as an alternative to spinal/epidural intervention, but the CSP came out to be the most comfortable and more emphasis should be given to the comfort as it increases the chance of success rate of the procedure.

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Section: Methodsmentioning

confidence: 99%

Comparison of neuraxial acoustic target window of the spine among rider sitting, cross leg, hamstring stretch, and classical sitting position: An observational study

Singh,

Sethi,

Kaur

et al. 2024

Journal of Anaesthesiology Clinical Pharmacology

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“…Sharma M et al, [30] assess the dimensions within the acoustic target window for neuraxial needle placement in term pregnancy in which 29 women completed the study. They observed significant increases in the lengths of posterior longitudinal ligament, ligamentum flavum and interlaminar distance at L3-L4 interspace.…”

Section: Sandoval Et Al[24]mentioning

confidence: 99%

Assessment of Increase in Dimensions Within the Acoustic Target Window for Neuraxial Needle Placement in Cross-Legged Sitting Position in Term Pregnancy Using Ultrasonography

2023

jcdr

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Background: Neuraxial anesthesia refers to placement of local anesthetic in or around the peripheral nervous system, it includes both spinal, epidural and caudal anesthesia. Spinal anesthesia is a neuraxial anesthesia technique in which local anesthetic is placed directly in the intrathecal space (subarachnoid space) which houses CSF. Aims: To assess the effect of different positions on the dimensions of paramedian target area in pregnant women using Ultrasonography. Methods: This prospective, observational study was conducted at LD Hospital, Govt. Medical College, Srinagar over a period of eighteen months. After obtaining approval from the Institutional Ethical Committee and informed consent of the patients for participation in the study. A total of 47 patients were included as per our inclusion and exclusion criteria. We assessed the increase in dimensions within the acoustic target window for neuraxial needle placement in Cross legged sitting position in term pregnancy using Ultrasonography. The various parameters we observed were age, gestational age, abdominal circumference, labouring status, comorbidities, comfort level of patients in both SP and CLP and increase in dimensions (PLL, LF, ILD) within acoustic target window using ultrasonography. Results: Sonographically visualized length of PLL (mean 20.85), ILD (mean 30.36), LF (mean 12.72) in CLP were significantly greater as compared to SP and this difference was statistically significant (P value <0.001). In addition the comfort level in CLP were significantly greater as compared to SP and this difference is statistically significant (P value <0.001). Conclusion:In conclusion, positioning the patient in Cross legged sitting position in term pregnancy significantly increased the length of PLL, ILD, LF compared to SP, suggesting easier performance of lumbar neuraxial block. Further clinical studies are required to determine if Cross legged sitting position improve the success rate of lumbar neuraxial block for an easier and more efficient insertion.

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Cross-legged position versus traditional sitting position for epidural catheter insertion for labor analgesia: a non-randomized prospective study

Serey,

Osse,

Repessé

et al. 2024

International Journal of Obstetric Anesthesia

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The crossed-leg position increases the dimensions within the acoustic target window for neuraxial needle placement in term pregnancy: a prospective observational study

Cited by 4 publications

References 16 publications

Comparison of neuraxial acoustic target window of the spine among rider sitting, cross leg, hamstring stretch, and classical sitting position: An observational study

Comparison of neuraxial acoustic target window of the spine among rider sitting, cross leg, hamstring stretch, and classical sitting position: An observational study

Assessment of Increase in Dimensions Within the Acoustic Target Window for Neuraxial Needle Placement in Cross-Legged Sitting Position in Term Pregnancy Using Ultrasonography

Cross-legged position versus traditional sitting position for epidural catheter insertion for labor analgesia: a non-randomized prospective study

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