Anesth Pain Med.  2013 Apr;8(2):127-131.

The correlation of cerebrospinal fluid pressure according to the degree of flexion and spinal block level in spinal anesthesia for Cesarean section

Affiliations
  • 1Department of Anesthesiology and Pain Medicine, Kyung Hee University Hospital at Gangdong, College of Medicine, Kyung Hee University, Seoul, Korea. esthesi@naver.com
  • 2Department of Anesthesiology and Pain Medicine, Kyung Hee University Medical Center, College of Medicine, Kyung Hee University, Seoul, Korea.

Abstract

BACKGROUND
The use of neuraxial anesthesia for Cesarean section has dramatically increased. There was little information about the relationship of cerebrospinal fluid (CSF) pressure according to the position and spinal block level in pregnant women. The aims of this study are to investigate the cerebrospinal fluid pressure according to the degree of flexion in the lateral position and block height after spinal anesthesia in pregnant women undergoing Cesarean section.
METHODS
We enrolled 40 patients, American Society of Anesthesiologists physical status I-II, aged 22-40 years, undergoing Caesarean section under spinal anesthesia. Patients were randomly divided into two groups. In group I, patients were placed in a full flexed position, and 10 mg of 0.5% hyperbaric bupivacaine was injected. In group II, the same dose of bupivacaine was injected when the hip and neck was straightened slowly. Following injection, the patients were immediately placed in supine position. The level of spinal anesthesia was checked by pinprick at 5, 10, 15, and 30 min after the subarachnoid injection.
RESULTS
There was significant difference in the cerebrospinal fluid pressure between full-flexed position and non-full-flexed position. The spinal block height level was T3-T5 in both groups, and there was no significant difference in the spinal block height level in both groups.
CONCLUSIONS
CSF pressures according to the degree of flexion in the lateral position during the subarachnoid injection have no significant correlation with the block level in spinal anesthesia for Cesarean section.

Keyword

Anesthesia; Cerebrospinal fluid pressure; Cesarean section; Obstetric; Spinal; Subarachnoid

MeSH Terms

Aged
Anesthesia
Anesthesia, Spinal
Bupivacaine
Cerebrospinal Fluid Pressure
Cesarean Section
Female
Hip
Humans
Neck
Pregnancy
Pregnant Women
Supine Position
Bupivacaine
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