VIDEO-BASED VISUAL AID VERSUS VERBAL INSTRUCTION FOR PATIENT POSITIONING DURING SUBARACHNOID BLOCK IN THE SITTING POSITION: A PROSPECTIVE RANDOMIZED OBSERVATIONAL STUDY

Abstract

Background: Subarachnoid block (SAB) is used in nearly 25–30% of regional anaesthetic procedures, and its success relies heavily on optimal patient positioning. Positioning difficulties are common, especially in elderly, obese, or anxious patients, with studies reporting up to 40% of patients requiring repeated attempts. Verbal instructions alone are frequently ineffective, so visual aids such as videos may improve patient understanding and cooperation. Aim and Objectives: To compare the effectiveness of visual aids versus verbal instructions in assisting patient positioning for the successful performance of SAB, in terms of procedural time, number of attempts required for successful needle placement, first-pass success rate, and overall anaesthesiologist satisfaction in each group. Materials and Methods: This prospective randomised observational study recruited 60 patients undergoing elective surgery under SAB, randomised into a Verbal Group (verbal positioning instructions) and a Visual Group (a short educational video/illustrated chart demonstrating the ideal sitting decubitus posture). All blocks were performed in the sitting position. Results: In the Verbal group, 19 patients (63%) required 240–300 seconds, 7 (23%) required 300–360 seconds, and 4 (13%) required 360–420 seconds. In the Visual group, 17 patients (57%) achieved successful placement within 180–240 seconds, 11 (37%) required 240–300 seconds, and none required more than 360 seconds. Overall procedural time was significantly shorter in the Visual group (253.0 ± 49.1 s) than the Verbal group (312.2 ± 56.3 s; p = 0.001). A single attempt was sufficient in 66.7% of the Visual group compared with 33.3% of the Verbal group achieving first-pass success (p = 0.020), and anaesthesiologist satisfaction was higher in the Visual group (96.7% vs 73.3%; p = 0.026). Conclusion: Visual aids significantly enhance patient comprehension and cooperation with the posture required for SAB. Video-based visual guidance led to shorter procedural time, fewer attempts, and a higher first-pass success rate, improving procedural efficiency and safety, and represents a simple, low-cost adjunct to routine preoperative counselling.