Comparison of Ease of Spinal Anaesthesia in Traditional vs Crossed Leg Sitting Position for Lower Abdominal and Lower Limb Surgeries

Background: Spinal anaesthesia is a common and effective regional technique for lower abdominal and lower limb surgeries.Optimal patient positioning is essential for success, and the traditional sitting position (TSP) may present challenges in patients with poor landmark visibility.The crossed-leg sitting position (CLSP) has been proposed to improve flexion and interspinous accessibility.To compare the ease of spinal anaesthesia between the traditional sitting position and the crossed-leg sitting position in patients undergoing lower abdominal and lower limb surgeries.Methods: This prospective, randomized controlled study included 80 adult patients (ASA I-II), divided equally into two groups: Group TSP (traditional sitting position) and Group CLSP (crossed-leg sitting position).The primary outcome was the number of attempts required for successful dural puncture.Secondary outcomes included the number of needle redirections, landmark palpability, time to cerebrospinal fluid (CSF) flow, visual analogue scale (VAS) score for patient comfort, and procedure-related complications.Results: Group CLSP had significantly fewer needle attempts (1.130.41 vs. 1.420.63;p=0.01), fewer redirections (1.20.8 vs. 2.11.3;p=0.004), and shorter time to CSF flow (30.26.4 sec vs. 38.69.8 sec; p=0.001) compared to Group TSP.Landmark palpability was better in CLSP (p=0.03), and VAS score for patient comfort was lower, indicating greater comfort (2.10.7 vs. 3.91.1;p<0.001).Complication rates were low and comparable between groups. Conclusion:The crossed-leg sitting position significantly improves the ease of spinal anaesthesia administration, enhances patient comfort, and reduces procedure time without increasing complication risk.CLSP may be considered a superior alternative to the traditional position in routine clinical practice.