Comparison of Straight Versus Flexed Back in Combined Spinal Epidural Anesthesia for Gynecological Procedure

The success of subarachnoid or epidural anesthesia is influenced by the quality of patient’s anatomical landmarks, the adequacy of patient positioning, and the provider’s level of experience. Incorrect posture resulting in multiple attempts, cause patient discomfort (thus rendering the technique unpleasant to the patient), post-dural puncture headache, and trauma to neural structures. Indeed, there are patients who are unable to adopt the ideal flexed posture due to arthritis, spondylosis, or pain due to limb trauma. It may be uncomfortable for some patients to assume a flexed posture. Hence, we worked on the above issues to determine the patient’s preferred posture and success of block performed in flexed posture and straight posture. Effect on hemodynamic parameters, attempts required, number of patients requiring manipulation of needle, number of patients requiring epidural supplementation. CSEA can be performed with equal ease in a seated patient regardless of the posture of the back being in a flexed or in a straight posture. CSEA block combines the rapidity, density and reliability of spinal block with the ability of continuous epidural to extend the duration of analgesia. It has been used in thousands of patients without any reports of major problems.