Efficacy Of Pre-Procedural Ultrasound Of Lumbar Spine In Improving The Procedural Skill For Subarachnoid Block

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.