Original Research Article DOI: 10.18231/2394-4994.2018.0049 Indian Journal of Clinical Anaesthesia, April-June, 2018;5(2):266-271 266 Saddle block spinal anesthesia and its effect on hemodynamic status and analgesia Neeta S. 1 , Sunil B. V. 2,* , Sonal Bhat 3 , Shaila Kamath 4 , Madhusudan U. 5 1, Assistant Professor, 2,3 Associate Professor, 4,5 Professor, Dept. of Anaesthesia, Kasturba Medical College, Manipal University of Higher Education, Mangalore, Karnataka, India *Corresponding Author: Email: drsunilbv@gmail.com Received: 21 st June, 2017 Accepted: 04 th October, 2017 Abstract Introduction: The sitting position is often used for patients undergoing spinal anesthesia especially when lower lumbar and sacral levels of sensory anesthesia are required. An advantage of this position is that the complications associated with it can be reduced. The present study assess the relation between saddle block anesthesia and the duration spent in sitting posture. Materials and Methods: Sixty ASA I and II patients were included in this study. In this randomized controlled study, patients planned to undergo perineal procedures were selected. Spinal anesthesia was given with 2.2 ml of 0.5 % hyperbaric bupivacaine and the patients were made to sit for one, six, twelve and twenty minutes before making them supine for the procedure. The data were analyzed using students ‘t’ test and .Chi - Square test . Results: Better hemodynamic stability was achieved by increasing the duration of sitting posture after spinal anesthesia. Also duration of motor /sensory blockade was decreased by increasing the duration of sitting position. Conclusion: The study shows that the duration of sitting position is inversely related to the duration and extent of sensory and motor blockade. .Also better hemodynamic stability can be achieved with saddle block anesthesia. Keywords: Spinal anesthesia, Sympathetic blockade, Hyperbaric bupivacaine, Cerebrospinal fluid. Introduction Spinal anesthesia is useful in procedures involving lower extrimity. Advantages of subarachnoid block include patient remaining fully awake, maintenance of normal physiology, lesser incidence of deep vein thrombosis and aspiration syndrome. 1 The disadvantages include hypotension, bradycardia, urinary retention and unduly prolonged motor paralysis. 2 The position of the patient during injection and the position for the next 20 minutes determines the distribution of hyperbaric solution like hyperbaric 0.5% bupivacaine. After that, distribution should no longer be significantly affected by position. The sitting position is often used for patients undergoing spinal anesthesia especially when lower lumbar and sacral levels of sensory anesthesia are required for surgical procedure such as perineal and urological procedures. The sitting position during and after injection; restricts the distribution of drug to lower lumbar and sacral roots. 3 However the relation between the nerve blockade produced and the duration spent in sitting posture still needs explanation. In the present study we are studying the relation between the nerve blockade produced and the time spent in sitting posture. Aim 1. To examine the duration of motor and extent of sensory blockade following spinal block with 0.5% bupivacaine and its relation with the different time durations spent in sitting position. 2. To assess the hemodynamic effects on time duration spent in sitting posture following spinal block. Materials and Methods Following hospital ethics committee clearance and written informed consent, 60 ASA I and II patients were included in the randomized controlled study. Patients posted for anal and peri anal surgeries under spinal anesthesia were included for the study. A. Inclusion criteria 1. American society of Anaesthesiology I and II 2. Age group 35-60 years. B. Exclusion criteria 1. Medically not fit for spinal anesthesia 2. Patient refusal 3. Deformities of vertebral column 4. Neurological diseases 5. Coagulaopathy 6. Valvular heart disease The prospective randomized study included 60 patients, divided into four groups based on the period of sitting. Group A: Patients were maintained in sitting position for one minutes. Group B: Patients were maintained in sitting position for six minutes. Group C: Patients were maintained in sitting position for twelve minutes. Group D: Patients were maintained in sitting position for twenty minutes.