Position provided to patient after spinal anaesthesia?

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Question

This question was previously asked in

SGPGI Staff Nurse Official Paper (Held On: 28 Feb, 2024 Shift 1)

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Answer 1

Correct Answer: Head low position

Rationale:

Spinal anaesthesia involves administering a local anaesthetic into the subarachnoid space, leading to temporary loss of sensation and motor function in the lower part of the body. Positioning the patient appropriately after spinal anaesthesia is critical to ensure proper distribution of the anaesthetic agent and to prevent complications such as hypotension or headache.
The head low position is generally recommended immediately after spinal anaesthesia, especially in cases where there is a risk of hypotension. This position helps to enhance venous return to the heart, thereby maintaining blood pressure and ensuring adequate cerebral perfusion.
Additionally, the head low position may assist in managing the spread of the anaesthetic agent, depending on the type and density of the anaesthetic used, to achieve the desired level of anaesthesia.

Explanation of Other Options:

Head end elevation

Rationale: Elevating the head end is not advised immediately after spinal anaesthesia because it may lead to pooling of blood in the lower extremities, reducing venous return and potentially causing hypotension. This position might be used later if the patient experiences a spinal headache, but not immediately post-anaesthesia.

Fowler’s position

Rationale: Fowler’s position involves sitting the patient up at an angle of 45-60 degrees. This is inappropriate immediately after spinal anaesthesia, as it can exacerbate hypotension and does not promote the desired distribution of the anaesthetic agent. It might be used later during recovery for patient comfort.

Prone position

Rationale: The prone position (lying face down) is not suitable post-spinal anaesthesia, as it does not support physiological stability or proper anaesthetic distribution. This position might be used for specific surgical procedures but not during recovery from spinal anaesthesia.

Conclusion:

The head low position is the most appropriate choice immediately after spinal anaesthesia to ensure patient stability, prevent hypotension, and achieve proper distribution of the anaesthetic agent. Other positions, such as head end elevation or Fowler’s position, may be employed later based on the patient's condition and specific clinical needs.