Does a Pre-Procedural Ultrasound Of the spine Improve The Performance For Spinal Anaesthesia

Completed

• Conditions: Patients posted for elective surgery under spinal anaesthesia

• Registration Number: CTRI/2018/02/012133
• Lead Sponsor: Department Of Anaesthesiology

Brief Summary

Spinalanaesthesia is one of the commonest procedures performed, and one of the firstskills to be acquired by an anaesthesiologist. It requires considerable skill, and demands a precise and totalunderstanding of regional anatomic relationships.  Acquiring adequate knowledge of the anatomyand orientation of central neuraxis, for performance of a successful block, isstill largely based on the “blind†landmark based procedure.  Radiological examination and simulation basedtraining techniques have been employed successfully, to better aid the teachingprocess.

In recent times, Ultrasonography has shedlight in various aspects in clinical anaesthesia, and has proven to be a usefultool for point of care procedures. Pertaining to central neuraxial blockade, USG guided procedures havebeen proven to identify and navigate the difficult anatomy, butbecause the procedure is time taking and there pose some difficulty inobtaining clear images, it is not routinely used in clinical practise.  However in a setting where practise makesperfect, to include its application as a teaching tool for the normal anatomy,may prove to improve the technique of lumbar puncture for spinal anaesthesia innormal as well as difficult anatomy, thereby reducing the distress experiencedby the patient with multiple attempts at spinal anaesthesia, also reducingincidence of associated complications (e.g hematoma, post dural punctureheadache) .  This study isdesigned to evaluate if a preprocedural ultrasonographic examination of the lumbarspine, improves the performance of lumbar puncture for spinal anaesthesia.

Detailed Description

Not available

Study Timeline

• Study Start: 2017-01-03
• Study Completion: 2018-08-14
• Last Update Posted: 2019-02-12

Recruitment & Eligibility

• Status: Completed
• Sex: All
• Target Recruitment: 200

Inclusion Criteria

ASA Grade I and II.

Exclusion Criteria

1. patient refusal 2) Contraindication for spinal anaesthesia – infection at site, coagulopathy, allergy to local anaesthetics 3) Spinal Deformity 4) BMI>35, Pregnancy 5) Previous Spine Surgery 6) Lower Limb Fractures.

Study & Design

• Study Type: Interventional
• Study Design: Not specified

Primary Outcome Measures

Name	Time	Method
procedural success in first needle pass	procedural success in first needle pass

Secondary Outcome Measures

Name	Time	Method
number of needle passes	the number of forward advancements of the spinal needle in a given interspinous space, i.e., withdrawal and redirection of spinal needle without exiting the skin
The number of attempts defined as the number of times the spinal needle is withdrawn from the skin and reinserted	defined as the number of times the spinal needle is withdrawn from the skin and reinserted
The time taken to detect CSF	time from first needle insertion till CSF detection

Trial Locations

Locations (1)

Mahatma Gandhi Medical College and Research Institute; 🇮🇳 Pondicherry, PONDICHERRY, India

Mahatma Gandhi Medical College and Research Institute

🇮🇳Pondicherry, PONDICHERRY, India

Archana Areti

Principal investigator

8374237095

archanaareti@gmail.com