Perbandingan Tingkat Keberhasilan Anestesi Spinal dengan Crossed-Leg Sitting Position dan Traditional Sitting Position di RSUP Dr Sardjito
Tulus Sihotang, dr. Calcarina Fitriani Retno Wisudarti, SpAn-TI, Subsp.TI(K) ; Dr. dr. Sudadi, Subsp.N.An(K), Subsp.An.R(K)
2026 | Tesis-Spesialis | S2 Anestesiologi
Latar Belakang : Posisi
pasien yang optimal menjadi faktor penting untuk keberhasilan anestesi spinal. Cross-Legged
Sitting Position (CLSP) merupakan alternatif posisi yang direkomendasikan
karena menyebabkan fleksi lutut dan pinggul, yang menghasilkan peningkatan
derajat fleksi lumbal sehingga potensial memudahkan prosedur anestesi spinal
dibandingkan Traditional Sitting Position (TSP).
Tujuan : Mengetahui perbandingan tingkat keberhasilan
anestesi spinal dengan CLSP dan TSP di RSUP Dr. Sardjito Yogyakarta.
Metode : Penelitian ini akan dilaksanakan dengan desain uji coba terkontrol acak label terbuka. Teknik anestesi spinal dilakukan dengan posisi CLSP dan TSP. Variabel utama yang diteliti adalah tingkat keberhasilan anestesi spinal pada upaya pertama pada masing-masing kelompok. dianalisis dengan chi square test. Perbedaan jumlah insersi dan durasi anestesi spinal dianalisis dengan independent T-Test atau uji Mann-Whitney. Hasil dinyatakan signifikan apabila nilai p<0>
Hasil : Pasien dibagi menjadi dua kelompok: 84 pasien dengan CLSP dan 84 pasien
dengan TSP. First attempt anestesi spinal pada kelompok CLSP berjumlah
74 (88,1%) dibandingkan TSP 67 (79,8%) dengan uji chi-square tidak
menunjukkkan perbedaan signifikan (p=0,141). Pada kelompok CLSP, subjek yang
menerima anestesi spinal menerima dua kali attempt 6 (7,1%) dan tiga
kali attempt 4 (4,8%). Pada kelompok TSP, pasien yang menerima anestesi
spinal dengan attempt dua kali 11 (13,1%) dan attempt tiga kali 6
(7,1%). Dengan menggunakan tes chi-square, tidak ditemukan hubungan yang
signifikan antara posisi pasien dan jumlah upaya anestesi spinal (p=0.330). Pada hasil uji mann whitney menunjukan bahwa
durasi insersi CLSP lebih cepat daripada TSP, dengan median waktu durasi
insersi anestesi CLSP dengan 12 detik sedangkan TSP adalah 20 detik (p=0.001).
Kesimpulan : Penelitian ini
menunjukkan bahwa crossed–leg sitting (CLSP) tidak signifikan
meningkatkan keberhasilan anestesi spinal dibandingkan dengan traditional
sitting position. Durasi
insersi anestesi spinal dengan CLSP lebih singkat secara bermakna dibandingkan
TSP.
Kata Kunci : Anestesi Spinal, Cross-Legged Sitting Position, Traditional
Sitting Position, first attempt spinal puncture, multiple attempt
Background:
Optimal patient positioning is an important factor for the success of spinal
anesthesia. The Cross-Legged Sitting Position (CLSP) is a recommended
alternative because it causes knee and hip flexion, resulting in increased
lumbar flexion, which potentially facilitates the spinal anesthesia procedure
compared to the Traditional Sitting Position (TSP).
Objective:
To compare the success rates of spinal anesthesia using the CLSP and TSP at Dr.
Sardjito General Hospital, Yogyakarta.
Methods: This study will be conducted using a nonblinded-randomized controlled trial design. Spinal anesthesia will be performed in both the CLSP and TSP positions. The main variable examined is the success rate of spinal anesthesia on the first attempt in each group, analyzed using the chi-square test. Differences in the number of insertions and duration of spinal anesthesia will be analyzed using the independent t-test or Mann-Whitney test. Results are considered significant if p<0>
Results:
Patients were divided into two groups: 84 patients with CLSP and 84 patients
with TSP. The first attempt success rate for spinal anesthesia in the CLSP
group (88.1%) was higher than in the TSP group (79.8%), but the chi-square test
showed no significant difference (p=0.141). In the CLSP group, 6 subjects
(7.1%) required two attempts and 4 subjects (4.8%) required three attempts. In
the TSP group, 11 patients (13.1%) required two attempts and 6 patients (7.1%)
required three attempts. Using the chi-square test, no significant association
was found between patient position and the number of attempts for spinal
anesthesia (p=0.330). The Mann-Whitney test showed that the insertion duration
for CLSP was shorter than for TSP, with the median insertion time for CLSP
being 12 seconds and for TSP 20 seconds (p=0.001).
Conclusion:
This study shows that the crossed-leg sitting position (CLSP) does not
significantly improve the success of spinal anesthesia compared with the
traditional sitting position. However, the duration of spinal anesthesia needle
insertion was significantly shorter in the CLSP group.
Keywords:
Spinal Anesthesia, Cross-Legged Sitting Position, Traditional Sitting Position,
first attempt spinal puncture, multiple attempt
Kata Kunci : Anestesi Spinal, Cross-Legged Sitting Position, Traditional Sitting Position, first attempt spinal puncture, multiple attempt
