Comparison of landmark-guided versus ultrasound assisted spinal anaesthesia for lower limb surgeries

Completed

• Conditions: Unspecified fracture of lower leg,

• Registration Number: CTRI/2022/10/046853
• Lead Sponsor: Dr Sujit Kshirsagar

Brief Summary

Subarachnoid block can be administered via two techniques;. Landmark guided  and USG guided. The current literature encourages the use of point-of-care ultrasound (POCUS) as adjunct to subarachnoid block (SAB) as it facilitates accurate needle placement, thereby reducing the number of needle redirections. Studies have shown that preprocedural USG’assisted neuraxial blocks reduces the number of attempts required for successful block.[1,2].[3]  Traditional spinal anaesthesia relied on the palpation of surface landmarks to identify the intervertebral levels; however, the possible occurrence of spine degeneration, supraspinous and interspinous ligament calcification, narrowing of intervertebral space, lumbar scoliosis, and deformities may make the identification of the intervertebral space unreliable and cause difficulties in needle insertion.

Detailed Description

Not available

Study Timeline

• Study Start: 2022-10-31
• Study Completion: 2023-06-08
• Last Update Posted: 2023-06-08

Recruitment & Eligibility

• Status: Completed
• Sex: All
• Target Recruitment: 104

Inclusion Criteria

1.Age 18 to 80yrs 2•height 145–180 cm 3•weight 50–100 kg 4•Both genders- male and female 5•ASA grade I and ASA grade II 6•Undergoing elective orthopaedic surgery of maximum 2 hrs of duration under spinal anaesthesia.

Exclusion Criteria

1•Age <18 yrs, > 80 yrs 2•Height<145cm, > 180 cm 3•Weight <50kgs, > 100 kg 4•ASA grade III and ASA grade IV 5•Patients with hepatic, cardiac, pulmonary, neuropsychiatric, renal or thyroid disease 6•Hypersensitivity to Bupivacaine 7•Any contraindication to spinal anaesthesia ( local infection, spinal deformity, coagulopathy).

Study & Design

• Study Type: Observational
• Study Design: Not specified

Primary Outcome Measures

Name	Time	Method
. total number of spinal needle redirections	every 3 min in first 30 min followed by repeat measurements every 5 min till the end of surgery.
2.The number of spinal needle attempts for a successful Subarachnoid block	every 3 min in first 30 min followed by repeat measurements every 5 min till the end of surgery.
3.successful Subarachnoid block rate in first attempt	every 3 min in first 30 min followed by repeat measurements every 5 min till the end of surgery.

Secondary Outcome Measures

Name	Time	Method
1.time taken to perform successful Subarachnoid block	2.patients’ satisfaction for the technique.

Trial Locations

Locations (1)

Sassoon General Hospital; 🇮🇳 Pune, MAHARASHTRA, India

Sassoon General Hospital

🇮🇳Pune, MAHARASHTRA, India

Dr Sujit Kshirsagar

Principal investigator

09022177719

bjsujit@gmail.com