{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T17:42:22Z","timestamp":1790876542696,"version":"4.1.0"},"reference-count":18,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"1","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2024,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background and Aims:<\/jats:title>\n                    <jats:p>The position of the patient during subarachnoid block has a role in its success. Landmarks of the spine can be easily identified in sitting position. Sitting position with legs parallel (LPSP) produces a reversal of lumbar lordosis. The crossed-leg sitting position (CLSP) is an alternative position. In this study, we compared the ease of performing subarachnoid blocks in these two positions. The objectives were to compare the attempts at subarachnoid placement, patient comfort, ease of landmark palpation, level of block, hypotension, and neonatal outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Material and Methods:<\/jats:title>\n                    <jats:p>This randomized trial was performed in 80 parturients posted for elective cesarean section. Parturients were assigned randomly to two groups. In group LPSP, the subarachnoid block was performed in sitting position with legs parallel and in group CLSP in the CLSP with knees and hips flexed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      The percentage of parturients with a successful subarachnoid block in the first attempt was higher in the CLSP than in LPSP group (87.5% versus 55%). The remaining 12.5% parturients in the CLSP group had successful block in the second attempt. In the LPSP group, 32.5% required two attempts and 12.5% required more than two attempts. This difference was statistically significant (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      -value of 0.003). The landmark was easily palpable in 92.5 versus 67.5% of parturients in CLSP and LPSP, respectively, with a\n                      <jats:italic toggle=\"yes\">P-<\/jats:italic>\n                      value of 0.014.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>CLSP is better than a sitting position with legs parallel for reducing the number of attempts and improving the ease of performing the subarachnoid block.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.4103\/joacp.joacp_11_22","type":"journal-article","created":{"date-parts":[[2024,2,9]],"date-time":"2024-02-09T02:00:25Z","timestamp":1707444025000},"page":"154-158","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":2,"title":["Comparison of induction of spinal anesthesia in sitting position with legs parallel and crossed for cesarean section: A randomized controlled trial"],"prefix":"10.4103","volume":"40","author":[{"given":"Nitu","family":"Puthenveettil","sequence":"first","affiliation":[{"name":"Department of Anaesthesia and Critical Care, Amrita Institute of Medical Sciences, Amrita Vishwa Vidyapeetham, Kochi, Kerala, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sajan","family":"Rahman","sequence":"additional","affiliation":[{"name":"Department of Anaesthesia and Critical Care, Amrita Institute of Medical Sciences, Amrita Vishwa Vidyapeetham, Kochi, Kerala, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arun Ramayyan","family":"Achary","sequence":"additional","affiliation":[{"name":"Department of Anaesthesia and Critical Care, Amrita Institute of Medical Sciences, Amrita Vishwa Vidyapeetham, Kochi, Kerala, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sobha","family":"Nair","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynaecology, Amrita Institute of Medical Sciences, Amrita Vishwa Vidyapeetham, Kochi, Kerala, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dilesh","family":"Kadapamannil","sequence":"additional","affiliation":[{"name":"Department of Anaesthesia and Critical Care, Amrita Institute of Medical Sciences, Amrita Vishwa Vidyapeetham, Kochi, Kerala, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jerry","family":"Paul","sequence":"additional","affiliation":[{"name":"Department of Anaesthesia and Critical Care, Amrita Institute of Medical Sciences, Amrita Vishwa Vidyapeetham, Kochi, Kerala, India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2024,2,8]]},"reference":[{"key":"R1-20240828","doi-asserted-by":"crossref","first-page":"21","DOI":"10.4103\/joacc.JOACC_47_19","article-title":"A comparison of time to achieve T5 blockade in lateral versus sitting position during elective cesarean section under spinal anesthesia: A randomized control trial","volume":"10","author":"Ramayyan Achary","year":"2020","journal-title":"J Obstet Anaesth Crit Care"},{"key":"R2-20240828","doi-asserted-by":"crossref","first-page":"23","DOI":"10.5152\/TJAR.2013.55","article-title":"Comparison of maternal and neonatal effects of combined spinal epidural anaesthesia in either the sitting or lateral position during elective cesarean section","volume":"42","author":"Tan","year":"2014","journal-title":"Turk J Anaesth Reanim"},{"key":"R3-20240828","first-page":"20255","article-title":"Efficacy of different positions for neuraxial anesthesia in caesarean section: A meta-analysis","volume":"9","author":"Xu","year":"2016","journal-title":"Int J ClinExp Med"},{"key":"R4-20240828","doi-asserted-by":"crossref","first-page":"851","DOI":"10.18203\/2320-6012.ijrms20170624","article-title":"Comparison of haemodynamic effects of lateral and sitting positions during induction of spinal anaesthesia for elective caesarean section","volume":"5","author":"Kharge","year":"2017","journal-title":"Int J Res Med Sci"},{"key":"R5-20240828","first-page":"956","article-title":"The cross-legged position for insertion of an epidural catheter during labour","volume":"38","author":"Francis","year":"2010","journal-title":"Anaesth Intensive Care"},{"key":"R6-20240828","doi-asserted-by":"crossref","first-page":"377","DOI":"10.4097\/kjae.2011.61.5.377","article-title":"Predicting the difficulty in performing a neuraxial blockade","volume":"61","author":"Kim","year":"2011","journal-title":"Korean J Anesthesiol"},{"key":"R7-20240828","doi-asserted-by":"crossref","first-page":"447","DOI":"10.1017\/S0265021502000716","article-title":"Predictors of successful neuroaxial block; 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