Resume: Objective: To study the effect of short-term Trendelenburg position on the distribution of hyperbaric bupivacaine solution and the achievement of sufficient sensory block during spinal anesthesia in patients undergoing laparoscopic cholecystectomy (LXE). Materials and methods: A randomized prospective study included 55 patients of ASA I-II category who were scheduled for LXE under spinal anesthesia. Patients were randomly divided into two groups: the main group (n=30) - short-term Trendelenburg position at 10° for 3 minutes immediately after the injection of 15 mg of hyperbaric bupivacaine 0.5%; the control group (n=25) - horizontal position. Main outcomes: degree of sensory block (Th), time to achieve the required level (Th4), frequency of sufficient block for LXE, hemodynamic changes, additional sedation and frequency of transition to general anesthesia. Results: The average peak of sensory block in the main group was Th4.2±0.8, and in the control group it was Th6.3±1.1 (p<0.01). Time to reach Th4 level: 6.3±1.2 minutes in the main group, 8.4±1.6 minutes in the control group (p<0.01). Sufficient block to perform LXE was observed in 28 of 30 patients in the main group (93.3%) and in 17 of 25 patients in the control group (68.0%) (χ², p=0.01). Frequency of transition to general anesthesia: 1/30 (3.3%) in the main group, 4/25 (16.0%) in the control group (p=0.09). The mean relative decrease in systolic blood pressure was not statistically different: 12.4±3.1% in the main group, 11.0±3.5% in the control group (p=0.12). Conclusions: The use of a short-term Trendelenburg position (10°, 3 minutes) after the administration of a hyperbaric solution of bupivacaine during spinal anesthesia promotes faster and higher propagation of the block. This increases the number of blocks sufficient for LXE without significantly increasing hemodynamic complications.

Key words: Keywords: spinal anesthesia, Trendelenburg position, laparoscopic cholecystectomy, sensory block, bupivacaine.

Pages: 151–155