Operating table height influences operator comfort and performance during neuraxial anaesthesia, particularly when the patient is positioned sitting. This study aimed to analyse the effect of operating table height on the success rate and incidence of complications during spinal anesthesia, particularly done by trainees/residents.
Patients who met the inclusion criteria and did not meet any exclusion criteria were randomised by computer software into two groups according to operating table height - set with puncture site at the level of the operator's umbilicus or the operator's xiphoid process - with group allocation concealed in opaque envelopes. Operators were enrolled by consecutive sampling, consisting of anaesthesiology residents who met the eligibility criteria and were present in the operating theatre during the study period. The outcomes assessed included subarachnoid block success, procedural duration from needle insertion to free flow of cerebrospinal fluid, the need for needle redirection, the need for needle reinsertion, operator comfort, operator posture analysis, and minor complications such as paresthesia or vascular puncture
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
SUPPORTIVE_CARE
Masking
NONE
Enrollment
88
Table height set so that the puncture site is at operators' umbilicus or xyphoid process level
Universitas Indonesia
Jakarta Pusat, Jakarta Special Capital Region, Indonesia
Procedure sucess
Determined as free flowing cerebrospinal fluid in spinal needle hub with total procedure time less than 10 minutes, redirection less than 5 minutes, and reinsertion less than 3 times, without occurrence of paresthesia and bloody tao
Time frame: Measured during procedure and readily assessed in under 30 minutes
Time to sucess
Time needed from spinal needle-skin contact to free flow of cerebrospinal fluid
Time frame: Measured during procedure and readily assessed in under 30 minutes
Redirection
Numbers of needle redirection needed at the same puncture site
Time frame: Measured during procedure and readily assessed in under 30 minutes
Reinsertion
Numbers of spinal needle insertion (after fully pulled out from the skin)
Time frame: Measured during procedure and readily assessed in under 30 minutes
Paresthesia
Abnormal unpleasant sensation (tingling, burning electric shock, or pain) on lower limbs during spinal procedure
Time frame: Measured during procedure and readily assessed in under 30 minutes
Blood contamination
Blood observed in spinal needle hub that went away after needle redirection
Time frame: Measured during procedure and readily assessed in under 30 minutes
Bloody tap
Aspirated blood in spinal needle hub that persists even after needle redirection and necessitate a reinsertion
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Time frame: Measured during procedure and readily assessed in under 30 minutes
Subjective comfort assessment
Subjective assessment of perceived comfort during procedure, asked simply as "comfortable" or "uncomfortable"
Time frame: Measured directly by asking the operators after procedure
Musculoskeletal complaints
Perceived sensation of aches, pains, tiredness, or stiffness in certain body areas as measured by nordic body map
Time frame: Measured right after procedure
Body postures score
Assessment of forced posture risk scoring using Rapid Entire Body Assessment
Time frame: Operators were documented during procedures and videos utilized for subsequent REBA scoring