COMPARISON OF PRE PROCEDURAL AND REAL TIME ULTRASOUND GUIDED SPINAL ANESTHESIA FOR TRAUMATIC LOWER LIMB INJURY

Objectives:The study aimed to compare real time ultrasound-guided approach with pre procedural ultrasound-guided approach for spinal anaesthesia in trauma patients.

Methods: 200 patients in two groups: group pre-procedure (PP) and group real time (RT) of 100 patients in each group using inclusion and exclusion criteria. Standard monitoring done and Spinal anesthesia was administered by a trained anesthetist. The outcome measures included the number of attempts took to access the subarachnoid space, number of skin punctures, time from first needle insertion to completion of the intrathecal injection, total procedure time, success rate of cerebrospinal fluid acquisition, failure and complications were recorded and statistical analysis was performed. A two-tailed p-value <0.05 was considered as statistically significant.  

Results: Mean number of needle passes, median number of skin puncture, total time for successful lumbar puncture, the block failure rate and procedural complications were significantly less in the RT group as compared to PP group. There are widely varying reports of the failure rate of spinal anesthesia in the literature. The individual studies have reported higher success rates (97% and 100%) using real-time US guidance than with pre-procedure ultrasound (80%).

Conclusion: Real-time ultrasound-guided technique is a clinically feasible, higher success rate, less time consuming and less complication rate as compared to preprocedural ultrasound guidance technique.