Yahya Muhammad, Ahmed Aliya, Fatima Iayla, Nasir Muhammad
Anaesthesiology, Aga Khan University Hospital, Karachi, PAK.
General Surgery, St. Luke's General Hospital, Kilkenny, IRL.
Cureus. 2023 Jan 7;15(1):e33476. doi: 10.7759/cureus.33476. eCollection 2023 Jan.
Spinal anesthesia is commonly used for various surgical procedures. Prediction of spinal anesthesia block height is always a challenging task for anesthetists. Higher than desired levels of spinal anesthesia blocks are associated with serious side effects, while inadequate block height does not provide satisfactory surgical anesthesia. In this study, we observed the relationship between the ratio of trunk length (TL) and square of the abdominal circumference (AC) and spinal anesthesia sensory block height in geriatric patients undergoing transurethral resection of the prostate (TURP).
MATERIAL & METHODS: This is a cross-sectional study conducted at the Aga Khan University Hospital Karachi, Pakistan, on geriatric patients undergoing TURP under spinal anesthesia. Forty-three elderly patients (American Society of Anaesthesiology level I-III) between 60 and 80 years were recruited for the study. In hospital wards, trunk length (TL) and abdominal circumference were recorded before the procedure. In the operating rooms, spinal anesthesia was performed at L3-L4 intervertebral space with 0.5% hyperbaric bupivacaine 10mg (2mls). Block height was measured by the placement of ice pads at different dermatomes. Spearman rank correlation coefficient was used to analyze the physical parameters (TL/AC) and spinal anesthesia block height. Results: The ratio of trunk length and square of the abdominal circumference (TL/AC) correlates with spinal anesthesia block height in geriatric patients, where the spearman rank correlation coefficient was r =-0.284 with p = 0.015.
The ratio of the long axis (TL) and transection area of the abdomen (AC), which coincides with (TL/AC), correlated with spinal anesthesia sensory block height. Hence, elderly patients with a low TL/ACratio will have higher block height after spinal anesthesia.
脊髓麻醉常用于各种外科手术。预测脊髓麻醉的阻滞平面高度一直是麻醉医生面临的一项具有挑战性的任务。高于预期水平的脊髓麻醉阻滞会伴有严重的副作用，而阻滞平面高度不足则无法提供令人满意的手术麻醉效果。在本研究中，我们观察了老年前列腺经尿道切除术（TURP）患者的躯干长度（TL）与腹围平方（AC）之比与脊髓麻醉感觉阻滞平面高度之间的关系。
这是一项在巴基斯坦卡拉奇阿迦汗大学医院对接受脊髓麻醉下TURP手术的老年患者进行的横断面研究。招募了43例年龄在60至80岁之间的老年患者（美国麻醉医师协会分级I - III级）参与研究。在医院病房，术前记录躯干长度（TL）和腹围。在手术室，于L3 - L4椎间隙注射10mg（2ml）0.5%的重比重布比卡因进行脊髓麻醉。通过在不同皮节放置冰垫来测量阻滞平面高度。采用Spearman等级相关系数分析身体参数（TL/AC）与脊髓麻醉阻滞平面高度之间的关系。结果：老年患者的躯干长度与腹围平方之比（TL/AC）与脊髓麻醉阻滞平面高度相关，Spearman等级相关系数r = -0.284，p = 0.015。
腹部的长轴（TL）与横截面积（AC）之比即TL/AC，与脊髓麻醉感觉阻滞平面高度相关。因此，TL/AC比值低的老年患者脊髓麻醉后阻滞平面高度会更高。
