Speaker for Nursing Conference 2019- Ladda Permpolprasert

Title: A Significance of Inspiratory Muscle Strength in Gynaecologic Patients after Spinal Anaesthesia

Ladda Permpolprasert

Siriraj Hospital, Thailand


Mrs. Ladda Permpolprasert, B.Sc. (Nursing), a full-time registered nurse, has got a Bachelor’degree in 1988, and become Nurse Anesthetist in 1995. Currently, she is interested in interventional studies in obstetric and gynaecolgic patients.


Background and Goal of Study
Spinal block, a method to provide anaesthetics intrathecally, is a favorable technique in patients with difficult ventilation, difficult intubation, or irritable airways.
However, spinal anaesthesia is not without adverse effects. Generally, it results in mild hypotension, weakness of diaphragm and respiratory muscles as well as cough impairment in a period of time. Apparently, the ventilatory impairment varies to the level of sympathetic blockage.
Investigators are curious about the facility of Mini Wright Peak Flow Meter to assess patient’s respiratory function pre and post spinal anaesthesia. Whether or not the peak expiratory flow rate (PEFR) is related to the level of sympathetic blockage? Is it possible to predict the respiratory outcome after the maneuver?
This prospective study, scheduled from April to September 2018, has been approved by Siriraj Institutional Review Board (COA: Si108/2018) and registered via Thai Clinical Trials Registry (TCTR20180921002).
The inclusion criteria were Gynaecologic patients undergoing elective exploratomy laparotomy under spinal anaesthesia, aged 18-65 years, ASA class I-II. The exclusion criteria were patients with BMI>30 kg/sqm, history of severe medical diseases, abnormal chest wall, kypho-scoliosis, using anti-psychotic or sedative drug, as well as pregnancy.
As a result, investigators would like to study the relationship between anaesthetic level and peak expiratory flow rate.