Abstract
BackgroundWe aimed to determine the effects of waist circumference and body mass index on spinal anesthesia levels. In total, 120 surgical patients who were between 18 and 65 years old and in the American Society of Anesthesiologists’ (ASA) I–III risk groups enrolled in this study. Patients were classified into three groups, depending on their weight. After a spinal block, we noted the time needed for the sensory block to reach the T10 level, the maximum sensory block level, the time needed for the sensory block to reach the maximum sensory block level, the time needed before the start of the motor block, and the Bromage scale for each patient.ResultsWe observed no significant demographic differences in age, gender, or ASA risk class between the groups; however, we found a statistically significant difference between the groups’ BMIs and waist circumferences. For the time needed for the spinal block to reach the T10 level, we observed a statistically significant difference between groups I, II, and III, and we also found a statistically significant difference between the groups’ comparing Bromage scales. Moreover, we found a statistically significant difference between the groups’ time needed (in minutes) for the block to reach the maximal upper dermatomal block level and, as BMIs and waist circumferences increased, the time needed to reach the maximal upper dermatomal block level. We also noted a statistically significant difference in waist circumference variability.ConclusionsThis study shows that body mass index and waist circumference can be used and interpreted as independent parameters reflecting the increasing incidence of obesity.
Highlights
We aimed to determine the effects of waist circumference and body mass index on spinal anesthesia levels
Patients who were in riskscoring groups I–III of the American Society of Anesthesiologists (ASA) and aged 18–65 were included in the study
Comparing the three groups’ demographic data, we found no statistically significant differences; we observed a strongly significant difference in Body mass index (BMI) between the three groups (Table 1)
Summary
We aimed to determine the effects of waist circumference and body mass index on spinal anesthesia levels. It is a regional anesthesia method that provides a reversible block in the spinal nerve root by injecting a local anesthetic drug. It offers many advantages, such as keeping the patients awake with spontaneous breathing, preserving such protective reflexes as coughing during operations, early mobilization, minimal lung. Over the last three decades, morbid obesity rates have tripled. The World Health Organization declared in 2005 that 1.6 billion people are overweight (BMI 25– 30), and 400 million people are obese (BMI > 30). In 2015, 2.3 billion people were estimated to be overweight, and 700 million were estimated to be obese (National Clinical Guideline 2014). As the incidence of obesity and morbid obesity (BMI > 40) increases, medical comorbidities—such as type 2 diabetes mellitus, hypertension, obstructive sleep apnea syndrome, cardiopulmonary diseases, and venous thromboembolism—have increased (Şahin and Doğru 2013)
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