Abdominal Crunch Position in Spinal Anesthesia: a Novel Sitting Position

Previous evidences suggested that traditional sitting position (flexion of knees approximately 90° and adduction of hips while feet rest on a stool) and lateral decubit position (sitting position with maximum extension of knees, adduction of hips, and forward bending) both reversed the lumbar lordosis and the number of spinal needle-bone contacts were identical when placing patients in these positions for neuraxial block. In this study, we suggested that abdominal crunch position reverses the lumbar lordosis and increase the gap of interspinal distance better than a traditional sitting position and lateral decubit position. One hundred patients ASA (American Society of Anesthesiologist) class I or II aged over 18 years old scheduled for elective surgeries under elective spinal anesthesia. We compared the traditional sitting, lateral decubit position, and abdominal crunch position. Our primary endpoint was to detect the increasing of interspinal gap by ultrasound. The gap of interspinal distance was statistically higher in the abdominal crunch position compared to traditional sitting position and lateral decubit position (P = 0.01). We suggested that the abdominal crunch position can to help our colleagues especially with the maximum spinal interval in the spinal anesthesia management.