Comparative evaluation of landmark-guided versus preprocedural ultrasound assisted paramedian technique in subarachnoid block for lower limb surgeries

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.