Influence of table height on the performances of residents while training to administer combined spinal-epidural anesthesia: a randomised trial.

Background: The present study aimed to evaluate whether the operating table height affected the success rate and incidence of complications of combined spinal-epidural anesthesia administered by residents during training. Methods One-hundred-and-eighty pregnant women, ASA I-II, were randomly allocated according to landmarks on the resident’s body: umbilicus (group U), lowest rib margin (R), and xiphoid process (X). The success rates of combined spinal-epidural anesthesia, the incidence of paresthesia and intravascular cannulation were recorded. Results There were no differences between the three groups in the success rates of combined spinal-epidural anesthesia, and the incidence of paresthesia and intravascular cannulation. However, paresthesia during epidural catheter advancement was more common on the left side (66.7%) than the right side (33.3%) (P=0.03). In group R, the success rate of epidural space puncture was higher during the residents’ third time (100%) than their first time (50%; P=0.01). Most residents (83%) preferred the table height at which the needle insertion point was at the level of their lowest rib margin. Conclusions The success rates of CESA during training did not be influenced by the operating table height which below the standing residents’ xiphoid process. But it may be helpful to suggest the residents to move the puncture point to the patients’ right slightly. It may be better to keep the table height at which the needle insertion point was level with the residents’ lowest rib margin. It was not just preferred by most of residents but also better for their training of performing epidural anesthesia.