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May 19, 1969

Spinal Anesthesia With The Patient Supine

Author Affiliations

Mount Sinai Hospital Cleveland

JAMA. 1969;208(7):1192. doi:10.1001/jama.1969.03160070070028

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To the Editor:—  In the article on "Spinal Anesthesia for Hip Pinning Given With the Patient Supine" by Alon P. Winnie, MD (207:1663, 1969), I am impressed by the ingenuity of the technique of administering a spinal anesthesia from under the operating room table through the opening in the fracture table and am willing to accept that the incidence of hypotension due to spinal anesthesia is reduced by avoiding moving the patient after administration of the anesthesia. However, I strongly disagree with the statement that "this simple change in technique has been shown to reduce... the mortality by more than one half."The author has not demonstrated, to my satisfaction, either that hypotension after spinal anesthesia is likely to be related to the subsequent mortality in hip surgery for the elderly patient, or that, as he states, "The two groups of patients studied were similar in every respect" except