USG Assisted Versus Surface Landmark Technique For Subarachanoid Block In Patients Undergoing Infra Umbilical Surgeries.

In USG group, ultrasound scanning in sitting position was done in preoperative room by an anesthesiologist. An ultrasound probe was placed transversely in the midline in the lumbar region to visualize the best view of the spinous process which appeared linear hypoechoeic acoustic shadow. Using M mode of USG L4-L5 and L3-L4 interlaminar space identified and marked using a surgical skin marking pen. Patient shifted to operation room and again in sitting position, 25G Quincke’s spinal needle was introduced in the marked point maintaining the same angle in which the USG probe was kept and subarachnoid space location was confirmed by backflow of clear CSF. 2-3 ml of 0.5% hyperbaric bupivacaine was given and patient made to lie down in supine position, Spinal uptake levels checked and surgery proceeded.  In the SLG group spine was palpated in the midline and two intervertebral spaces L4-L5 and L3-L4 were palpated and spinal anaesthesia is performed by conventional palpatory surface landmark technique. And 2-3 ml of 0.5% hyperbaric Bupivacaine was given .The first pass needle insertion success and number of needle puncture attempts taken to achieve spinal anaesthesia were recorded.