• Users Online: 363
  • Home
  • Print this page
  • Email this page
Home About us Editorial board Search Ahead of print Current issue Archives Submit article Instructions Subscribe Contacts Login 
ORIGINAL ARTICLE
Year : 2022  |  Volume : 23  |  Issue : 1  |  Page : 38-43

Preprocedural ultrasound assessment of landmarks of paramedian approach for subarachnoid block in geriatric population


Department of Anaesthesiology, Kalinga Institute of Medical Sciences, Bhubaneswar, Odisha, India

Correspondence Address:
Dr. Amrita Panda
Department of Anaesthesiology, Kalinga Institute of Medical Sciences, Bhubaneswar - 751 024, Odisha
India
Login to access the Email id

Source of Support: None, Conflict of Interest: None


DOI: 10.4103/TheIAForum.TheIAForum_97_21

Rights and Permissions

Background: Paramedian spinal anesthesia is the preferred anesthetic technique in the elderly. This conventional approach is occasionally challenged by difficulty in identifying landmarks accurately. Neuraxial ultrasound aims to overcome these inaccuracies. Objective: The objective was that the routine use of preprocedural ultrasound assessment of landmarks for paramedian spinal in geriatric population improves the efficacy of spinal anesthesia by reducing the number of attempts and redirections. Materials and Methods: Sixty consenting elderly patients aged 60 year or above, posted for elective surgery under spinal anesthesia, were enrolled in the study. Participants were assigned at random to receive spinal anesthesia by the paramedian approach by either conventional landmark guidance (Group CP) or preprocedural ultrasound-assisted (Group PP) technique. Results: The number of needle redirections was not significant and the success rate at the first attempt with no redirection was higher in the ultrasound compared with the landmark group. However, the mean insertion attempts were indifferent. The preprocedural ultrasound-assisted approach required an insignificantly shorter time for administering spinal anesthesia than the landmark-guided technique (48.87s [67.65] vs. 50.67s [50.19]) [P = 0.90]. The periprocedural pain scores (2.90[2.07] vs. 2.87[1.57]) [P = 0.94] and willingness for a similar future intervention (66.7 vs. 66.7%) were comparable among the groups. Conclusion: The use of preprocedural ultrasonography for paramedian approach to spinal anesthesia is not superior to the conventional landmark guidance in achieving successful dural tap at L3-L4 interspace in elderly adult population and should be limited to a setting with expert operators and selected patients for whom conventional methods may be technically challenging.


[FULL TEXT] [PDF]*
Print this article     Email this article
 Next article
 Previous article
 Table of Contents

 Similar in PUBMED
   Search Pubmed for
   Search in Google Scholar for
 Related articles
 Citation Manager
 Access Statistics
 Reader Comments
 Email Alert *
 Add to My List *
 * Requires registration (Free)
 

 Article Access Statistics
    Viewed542    
    Printed14    
    Emailed0    
    PDF Downloaded20    
    Comments [Add]    

Recommend this journal