Effect of the Height of the Operating Table During Spinal Anesthesia

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.

Study Overview

• Status: Unknown
• Conditions: Anesthesia, Spinal [E03.155.086.331]; Operating Tables [E07.325.662]
• Intervention / Treatment: Procedure: Umbilicus; Drug: Umbilicus Bupivacaine; Procedure: Lowest rib margin; Drug: Lowest rib margin Bupivacaine; Procedure: Xiphoid; Drug: Xiphoid Bupivacaine; Procedure: Nipple; Drug: Nipple Bupivacaine

Detailed Description

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.

• Study Type: Interventional
• Enrollment (Anticipated): 60
• Phase: Not Applicable

Contacts and Locations

Study Locations

• Korea, Republic of
  • Gyeonggido
    • Seongnam, Gyeonggido, Korea, Republic of, 463707
      • Recruiting
      • Seoul National University Bundang Hospital

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 18 years to 75 years (ADULT, OLDER_ADULT)
• Accepts Healthy Volunteers: No
• Genders Eligible for Study: All

Description

Inclusion Criteria:

• undergoing elective surgery under spinal anesthesia

Exclusion Criteria:

• body mass index (BMI)>30
• history of spine operation or severe anatomical abnormalities of spine

Study Plan

How is the study designed?

Design Details

• Primary Purpose: DIAGNOSTIC
• Allocation: RANDOMIZED
• Interventional Model: PARALLEL
• Masking: SINGLE

Number of Arms

4

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
EXPERIMENTAL: Umbilicus; 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.	Procedure: Umbilicus; 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; Drug: Umbilicus Bupivacaine; If freely flowing of CSF is detected, appropriate dose of MARCAINE was injected in all interventional groups.; Other Names: Bupivacaine
ACTIVE_COMPARATOR: Lowest rib margin; 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.	Procedure: Lowest rib margin; The height of the operating table which set at the needle insertion point of anesthetists; the level of lowest rib margin; Drug: Lowest rib margin Bupivacaine; If freely flowing of CSF is detected, appropriate dose of MARCAINE was injected in all interventional groups.; Other Names: Bupivacaine
ACTIVE_COMPARATOR: Xiphoid; 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.	Procedure: Xiphoid; The height of the operating table which set at the needle insertion point of anesthetists; the level of xiphoid; Drug: Xiphoid Bupivacaine; If freely flowing of CSF is detected, appropriate dose of MARCAINE was injected in all interventional groups.; Other Names: Bupivacaine
ACTIVE_COMPARATOR: Nipple; 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.	Procedure: Nipple; The height of the operating table which set at the needle insertion point of anesthetists; the level of nipple; Drug: Nipple Bupivacaine; If freely flowing of CSF is detected, appropriate dose of MARCAINE was injected in all interventional groups.; Other Names: Bupivacaine

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Time Frame
The angle between the patient's skin and the spinal needle	during procedure

Secondary Outcome Measures

Outcome Measure	Time Frame
anesthesiologist's subjective discomfort	during procedure
the degree of anesthesiologist's joint flexion	during procedure

Collaborators and Investigators

• Sponsor: Seoul National University Hospital
• Investigators: Study Director: Jinhee Kim, MD,PhD, Seoul National University Hospital

Publications and helpful links

General Publications

• 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.
• 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.

Study record dates

Study Major Dates

• Study Start: September 1, 2014
• Primary Completion (ANTICIPATED): August 1, 2015
• Study Completion (ANTICIPATED): August 1, 2015

Study Registration Dates

• First Submitted: November 27, 2014
• First Submitted That Met QC Criteria: February 26, 2015
• First Posted (ESTIMATE): February 27, 2015

Study Record Updates

• Last Update Posted (ESTIMATE): February 27, 2015
• Last Update Submitted That Met QC Criteria: February 26, 2015
• Last Verified: September 1, 2014

More Information

Terms related to this study

• Additional Relevant MeSH Terms: Physiological Effects of Drugs; Central Nervous System Depressants; Peripheral Nervous System Agents; Sensory System Agents; Anesthetics; Anesthetics, Local; Bupivacaine
• Other Study ID Numbers: I-2014-6010