Comparision of hemodynamic changes, movement, duration of surgery and pain between lateral and supine posision after spinal anesthesia in transurethral lithotrips

Abstract

Introduction: Patient position during surgery is an important issue that can affect vital indices. Objectives: This study was conducted to compare hemodynamic changes, movements, surgery length, and pain during transurethral lithotripsy (TUL) in supine and lateral positions. Patients and Methods: This double-blind clinical trial was conducted on 76 patients who were candidate for TUL, randomized to two groups of 38 for each. In the lateral group, after inducing spinal anesthesia, the patients were positioned lateral and in supine group, the patients were positioned supine immediately after injecting anesthetic. Vital signs were recorded at six intervals; 5 minutes before anesthesia and 1, 5, 10, 15, and 20 minutes after anesthesia. In addition, movements and pain during surgery were assessed. Data analysis was conducted by descriptive statistics, independent t test, and repeated measures ANOVA in SPSS 22. Results: There were significant differences in changes in systolic blood pressure, diastolic blood pressure, and mean arterial pressure at different intervals between the two groups in such a way that hemodynamic stability was greater in the lateral group (P < 0.05). There were no significant differences in changes in heart rate at all studied intervals between the two groups (P > 0.05). Surgery length, movement and pain during surgery were not significantly different between the two groups (P < 0.05). Conclusion: Hemodynamic changes especially blood pressure were less remarkable in patients undergoing spinal anesthesia in TUL at lateral position than those in supine position. Additionally, no significant differences in patients' movement and surgery, and surgery length between the two positions was detected.