Spinal anesthesia compared to the general anesthesia has advantages of decrease blood loss, better cardiovascular stability and post-operative pain control. But the spinal anesthesia for lower limb orthopedic surgeries in prone position is not well described in the literature. The aim of this study was to know the safety and feasibility of spinal anesthesia for lower limb orthopedic surgeries in prone position.
Patients and Methods: Patients undergoing lower limb orthopedic surgeries in prone position under spinal anesthesia in a tertiary health care facility over a period of 10 years were included in this study. Patient demographic data, surgical procedure, ASA grade, position for spinal anesthesia, local anesthetic with or without opioids, level of sensory block and complication if any were recorded retrospectively.
Results: A total 104 patients were included in our study. The Majority of our patients were male. Fifty two percent had fracture calcaneus surgery. Average height of spinal block was thoracic 9 vertebra. Patients turned to prone position after 8.59 ± 3.6 minutes. Eighty seven percent patients received fentanyl with heavy bupivacaine. The most frequent complication was hypotension (18.3%). There were significant difference between occurrence of complication and patients age, gender, BMI, ASA grading and comorbid condition. No major complications occurred which needed to turn the patient back in to supine after prone positioning.
Conclusion: Spinal anesthesia and prone position is safe and feasible for lower limb orthopedic surgeries. Our study showed that complications of lower limb orthopedic surgeries in prone position under spinal anesthesia were negligible.
Nissar Shaikh, Mohamed Alkhayarin, AR Raju Vegesna and Syed Imran Ghouri