28 -11 (85) 2025 - Zukhritdinov A.I., Sadikova M.A. - IMPORTANCE OF SHORT-TERM TRENDELENBURG POSITION FOR ACHIEVING ADEQUATE ANALGESIA UNDER SPINACH ANESTHESIA DURING LAPAROSCOPIC CHOLECYSTETOMY

IMPORTANCE OF SHORT-TERM TRENDELENBURG POSITION FOR ACHIEVING ADEQUATE ANALGESIA UNDER SPINACH ANESTHESIA DURING LAPAROSCOPIC CHOLECYSTETOMY

Zukhritdinov A.I. - Andijan State Medical Institute

Sadikova M.A. - Andijan State Medical Institute

Resume

Objective: To study the effect of short-term Trendelenburg position on the distribution of hyperbaric bupivacaine solution and the achievement of sufficient sensory block during spinal anesthesia in patients undergoing laparoscopic cholecystectomy (LXE). Materials and methods: A randomized prospective study included 55 patients of ASA I-II category who were scheduled for LXE under spinal anesthesia. Patients were randomly divided into two groups: the main group (n=30) - short-term Trendelenburg position at 10° for 3 minutes immediately after the injection of 15 mg of hyperbaric bupivacaine 0.5%; the control group (n=25) - horizontal position. Main outcomes: degree of sensory block (Th), time to achieve the required level (Th4), frequency of sufficient block for LXE, hemodynamic changes, additional sedation and frequency of transition to general anesthesia. Results: The average peak of sensory block in the main group was Th4.2±0.8, and in the control group it was Th6.3±1.1 (p<0.01). Time to reach Th4 level: 6.3±1.2 minutes in the main group, 8.4±1.6 minutes in the control group (p<0.01). Sufficient block to perform LXE was observed in 28 of 30 patients in the main group (93.3%) and in 17 of 25 patients in the control group (68.0%) (χ², p=0.01). Frequency of transition to general anesthesia: 1/30 (3.3%) in the main group, 4/25 (16.0%) in the control group (p=0.09). The mean relative decrease in systolic blood pressure was not statistically different: 12.4±3.1% in the main group, 11.0±3.5% in the control group (p=0.12). Conclusions: The use of a short-term Trendelenburg position (10°, 3 minutes) after the administration of a hyperbaric solution of bupivacaine during spinal anesthesia promotes faster and higher propagation of the block. This increases the number of blocks sufficient for LXE without significantly increasing hemodynamic complications.

Keywords: spinal anesthesia, Trendelenburg position, laparoscopic cholecystectomy, sensory block, bupivacaine.

First page

151

Last page

155

For citation:Zukhritdinov A.I., Sadikova M.A. - IMPORTANCE OF SHORT-TERM TRENDELENBURG POSITION FOR ACHIEVING ADEQUATE ANALGESIA UNDER SPINACH ANESTHESIA DURING LAPAROSCOPIC CHOLECYSTETOMY//New Day in Medicine 11(85)2025 151-155 https://newdayworldmedicine.com/en/new_day_medicine/11-85-2025

List of References

1. Tarkkila J.P., Kaukinen S. Bemorning holatining giperbarik orqa miya anesteziyasi tarqalishiga ta’siri. Anesteziya. 2021;76(4):589-595.
2. Lee Y. va boshqalar. Trendelenburg og‘ishida orqa miya anesteziyasida gemodinamik o‘zgarishlar. J Clin Anesth. 2020;62:109-115.
3. Bazarov U.T., Xamidov A.R. Orqa miya anesteziyasida sezgirlik blokini optimallashtirish: bemor holatining roli. Anesteziologiya va intensiv terapiya. 2021;68(2):27-33.
4. Petrov V.V. Orqa miya anesteziyasi ostida laparoskopik xoletsistektomiyaga zamonaviy yondashuvlar. Jarrohlik. 2023;4:12-18.
5. Sag‘dullayev F.Sh., Abduraxmanova N.N. Laparoskopik amaliyotlarda orqa miya og‘riqsizlantirishini qo‘llashning klinik jihatlari. Anesteziologiya axborotnomasi. 2022;29(3):45–51.

   file

   download