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The purpose of this study is to analyze the accuracy of needle insertion and the discomfort during different ergonomic conditions faced by anesthesiologists during spinal anesthesia. In particular,the investigators intend to compare the angles between the patients' back and the inserted spinal needle in the coronal plane at different operating table heights.
Sixty patients will be recruited undergoing elective surgery under spinal anesthesia. The patients will be randomly allocated to one of four groups: Group U, L, X, and N. These acronyms indicate the heights of the operating table which set at the needle insertion point of anesthetists, namely the level of umbilicus, lowest rib margin, xiphoid process, and nipple in a standing posture. The angle between the patient's skin and the spinal needle will be measured by the protractor in the coronal and sagittal plane. The anesthesiologists will be asked to record the subjective general discomfort graded by Numeric Rating Scale. And the degree of neck, lower back, knee, and elbow flexion of the anesthesiologists will be measured by taking pictures during procedure.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Umbilicus | Experimental | The height of the operating table which set at the needle insertion point, is the level of umbilicus of the anesthesiologist in a standing posture. |
|
| Lowest rib margin | Active Comparator | The height of the operating table which set at the needle insertion point, is the level of lowest rib margin of the anesthesiologist in a standing posture. |
|
| Xiphoid | Active Comparator | The height of the operating table which set at the needle insertion point, is the level of xiphoid of the anesthesiologist in a standing posture. |
|
| Nipple | Active Comparator | The height of the operating table which set at the needle insertion point, is the level of nipple of the anesthesiologist in a standing posture. |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Umbilicus | Procedure | Depending on the height of the operating table, the insertion angle of the spinal needles would be vary. The investigators intend to find the optimal angle and the height of the table to provide that. The height of the operating table which set at the needle insertion point of anesthetists; the level of umbilicus |
| Measure | Description | Time Frame |
|---|---|---|
| The angle between the patient's skin and the spinal needle | during procedure |
| Measure | Description | Time Frame |
|---|---|---|
| anesthesiologist's subjective discomfort | during procedure | |
| the degree of anesthesiologist's joint flexion | during procedure |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Jinhee Kim, MD,PhD | Contact | 82-31-787-7505 | shm@snubh.org | |
| Hyerim Kim, MD | Contact | 82-10-7120-9110 | kimhl911@daum.net |
| Name | Affiliation | Role |
|---|---|---|
| Jinhee Kim, MD,PhD | Seoul National University Hospital | Study Director |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Seoul National University Bundang Hospital | Recruiting | Seongnam | Gyeonggido | 463707 | South Korea |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 24355831 | Background | Lee HC, Yun MJ, Hwang JW, Na HS, Kim DH, Park JY. Higher operating tables provide better laryngeal views for tracheal intubation. Br J Anaesth. 2014 Apr;112(4):749-55. doi: 10.1093/bja/aet428. Epub 2013 Dec 18. | |
| 19707143 | Background | Ajmal M, Power S, Smith T, Shorten GD. An ergonomic task analysis of spinal anaesthesia. Eur J Anaesthesiol. 2009 Dec;26(12):1037-42. doi: 10.1097/EJA.0b013e3283317dc9. |
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| Lowest rib margin | Procedure | The height of the operating table which set at the needle insertion point of anesthetists; the level of lowest rib margin |
|
| Xiphoid | Procedure | The height of the operating table which set at the needle insertion point of anesthetists; the level of xiphoid |
|
| Nipple | Procedure | The height of the operating table which set at the needle insertion point of anesthetists; the level of nipple |
|
| Umbilicus Bupivacaine | Drug | If freely flowing of CSF is detected, appropriate dose of MARCAINE was injected in all interventional groups. |
|
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| Lowest rib margin Bupivacaine | Drug | If freely flowing of CSF is detected, appropriate dose of MARCAINE was injected in all interventional groups. |
|
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| Xiphoid Bupivacaine | Drug | If freely flowing of CSF is detected, appropriate dose of MARCAINE was injected in all interventional groups. |
|
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| Nipple Bupivacaine | Drug | If freely flowing of CSF is detected, appropriate dose of MARCAINE was injected in all interventional groups. |
|
|
| ID | Term |
|---|---|
| D046288 | Body Piercing |
| D002045 | Bupivacaine |
| ID | Term |
|---|---|
| D046289 | Body Modification, Non-Therapeutic |
| D003357 | Cosmetic Techniques |
| D013812 | Therapeutics |
| D013514 | Surgical Procedures, Operative |
| D000813 | Anilides |
| D000577 | Amides |
| D009930 | Organic Chemicals |
| D000814 | Aniline Compounds |
| D000588 | Amines |
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