The aim of this study was to compare the successful spinal puncture among patients with pendant position in comparison with those who used traditional sitting position for caesarean section.

Approval from Ethical Committee of Faculty of Medicine University of Indonesia was acquired prior conducting the study. Subjects were given informed consent before enrolling the study. Subjects were divided into Group A for traditional sitting position (n=154) and Group B for pendant position (n=154). The outcome parameters recorded were the number of attempt for the successful spinal puncture, the number of spinal needle-bone contact and the duration to perform spinal puncture. Data were analyzed by using Statistical Package for Social Scientist (SPSS) version 21.0. Numerical data was served in median with minimal and maximal value. Numerical data was analyzed by using Mann-Whitney test. Categorical data was served by using relative risk (RR) with 95% confidence interval (95% CI) and was analyzed by using Chi-Square test.

Inclusion Criteria:

• pregnant women aged 18-45 years old
• Body Mass Index (BMI) 18-35 kg/m2
• physical status American Society of Anesthesiologists (ASA) I-III
• planned to undergo cesarean section with spinal anesthesia and signed the informed consent form

Exclusion Criteria:

• Patients with any contraindication for spinal anesthesia (infection on injection site, coagulation disorder, severe hypovolemia, increased intracranial pressure, aortic and/or mitral stenosis)
• pregnancy with head entrapment of the fetus, umbilical cord prolapse, feet presentation,
• Patient with eclampsia
• Patient with cardiovascular diseases
• Patient with scoliosis
• Patient with history of lumbar surgery
• Patient with unpalpable intervertebral space due to thick fatty tissue or edema.

Drop out criteria:

- spinal block was failed or only partial block