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In these prospective observational study, the investigators are trying to evaluate (1) the influence of body-mass index on spinal anesthetic outcome and (2) the determinants on spinal anesthetic outcome by logistic regression analysis.
Although the spread of spinal anesthetic drug is unpredictable, patients factors (age, gender, height,weight, body-mass index), spinal anatomy, anesthetic drug dose, and lumbosacral cerebrospinal fluid volume are known to be the determinants of sensory block level. Among these determinants, the influence of body-mass index (BMI) on spinal anesthesia is controversial, and there is no specific guideline showing the relative priority of these determinants.
Therefore, in these prospective observational study, the investigators are trying to evaluate (1) the influence of body-mass index on spinal anesthetic outcome and (2) the relative influence of these determinants on spinal anesthetic outcome by logistic regression analysis.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Obese group | patients with BMI >= 30.0 kg/m2 who received spinal anesthesia with heavy marcaine |
| |
| Non-obese group | patients with BMI < 30.0 kg/m2 who received spinal anesthesia with heavy marcaine |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Spinal anesthesia (heavy bupivacaine) | Drug | Spinal anesthesia with heavy bupivacaine of 6, 7, 8, 9, 10, 11 mg |
|
| Measure | Description | Time Frame |
|---|---|---|
| spinal anesthetic success/ failure | when (1) a bilateral T12 sensory block to pinprick within 15 minutes of intrathecal drug administration with sensory/motor block scale ≥ 2 and (2) the level of sensory block at the end of surgery was higher than or equal to T12 with sensory/motor block scale ≥ 2. | at 2 hour after the anesthetic induction |
| Measure | Description | Time Frame |
|---|---|---|
| Peak level of sensory block at anesthesia induction | Sensory block levels determined by pinprick test | during 20 min after anesthetic induction |
| Spinal anesthesia sensory/motor block level at the end of surgery |
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Inclusion Criteria:
Exclusion Criteria:
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Patients who are undergoing spinal anesthesia in Samsung Medical Center during study period
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| Name | Affiliation | Role |
|---|---|---|
| Sangmin M. Lee, MD, PhD | Samsung Medical Center | Principal Investigator |
| Ji Sun Hahm, MD | Samsung Medical Center | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Samsung Medical Center | Seoul | 135-710 | South Korea |
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| ID | Term |
|---|---|
| D000775 | Anesthesia, Spinal |
| ID | Term |
|---|---|
| D000765 | Anesthesia, Conduction |
| D000758 | Anesthesia |
| D000760 | Anesthesia and Analgesia |
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Spinal anesthesia block level as determined by Pinprick sensory test with Bromage scale.
Sensory 0 = an ability to appreciate a pinprick as sharp; 1 = perception of a pinprick as less sharp than in unblocked areas; 2 = perception of a pinprick as touch but not sharp (analgesia); 3 = an inability to feel pinprick(anesthesia).
Bromage Scale 0 = ability to lift an extended knee at the hip; 1 = ability to flex the knee but not to lift an extended leg; 2 = ability to flex toes only; 3 = inability to move.
| 2 hours after induction (at the end of surgery) |
| the incidence of tourniquet pain | the incidence of tourniquet pain during the tourniquet time reported by the patient (NRS >= 2) | at 90 min afer anesthetic induction |
| Incidence of hypotension, bradycardia | Incidence of hypotension, bradycardia total dose of ephedrine Lowest mean blood pressure Incidence of vomiting, shivering | during 2 hours after anesthesia induction |