Yoga tarzı bağdaş oturuşu, nöraksiyal analjezi ve / veya doğum anestezi için en iyi pozisyon mudur?

Abstract

The patient's position including standard traditional sitting position (TSP) or lateral position during insertion of the epidural catheter plays a major role in the success of labour epidural analgesia. Recently, crossed-legged sitting position (CLSP) has been recommended as an alternative for the administration of regional analgesia for labour. The authors compared the cross-legged sitting position (CLSP) with traditional sitting position (TSP) in performing epidural analgesia for labor to elucidate which is an easier option for placing an epidural catheter. The rate of successful epidural insertion at the first attempt was higher in CLSP group than that of TSP group. The landmark, needle-bone contact and comfort during positioning were comparable between the groups. In an earlier study, maternal and neonatal effects of either TSP or lateral decubitus position to perform combined spinal epidural (CSE) anaesthesia in otherwise healthy parturients underwent elective caesarean section (CS) were investigated. Rate of performing CSE at the 1st attempt was higher in the TSP than that of lateral decubitus position. Incidence of paresthesia due to Whitacre spinal needle used for CSE was less in the TSP than that of lateral decubitus. Thus, choice of CLSP over TSP for epidural block during labor analgesia and TSP over lateral decubitus for CSE for CS seem to be better in terms of ease of insertion. In a study including 60 pregnant women with lumbopelvic pain practicing yoga in CLSP had lower pain compared to standard posture exercise. Yet to our knowledge, there is no study that primarily compares the three positions (TSP, CLSP or lateral decubitus) altogether to demonstrate the ease of insertion of epidural catheter for vaginal and caesarean delivery to provide analgesia and/or anesthesia. If CLSP could have been one of the competitors of the two studies, we would be able to suggest one position over another without any hesitation.