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Comparative evaluation of three techniques for paramedian subarachnoid block: Point-of-care preprocedural ultrasound assisted, real-time ultrasound guided and landmark based

BACKGROUND AND AIMS: Preprocedural ultrasound (US) assisted and real-time US-guided subarachnoid block (SAB) are useful adjuncts for successful SAB. This study compared the feasibility and efficacy of real-time US-guided SAB with preprocedural US-assisted and landmark-based SAB using paramedian appr...

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Autores principales: Bhardwaj, Deepak, Thakur, Lokesh, Sharma, Shalini, Rana, Shelly, Gupta, Bhanu, Sharma, Charu
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Wolters Kluwer - Medknow 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9116633/
https://www.ncbi.nlm.nih.gov/pubmed/35601040
http://dx.doi.org/10.4103/ija.ija_373_21
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author Bhardwaj, Deepak
Thakur, Lokesh
Sharma, Shalini
Rana, Shelly
Gupta, Bhanu
Sharma, Charu
author_facet Bhardwaj, Deepak
Thakur, Lokesh
Sharma, Shalini
Rana, Shelly
Gupta, Bhanu
Sharma, Charu
author_sort Bhardwaj, Deepak
collection PubMed
description BACKGROUND AND AIMS: Preprocedural ultrasound (US) assisted and real-time US-guided subarachnoid block (SAB) are useful adjuncts for successful SAB. This study compared the feasibility and efficacy of real-time US-guided SAB with preprocedural US-assisted and landmark-based SAB using paramedian approach. METHODS: The study enroled 150 American Society of Anesthesiologists I and II patients, aged 20–65 years, scheduled for lower limb orthopaedic surgery under SAB. In group L (n = 50), the patients underwent landmark-guided SAB utilising paramedian approach. In group P (n = 50), preprocedural US-assisted SAB was instituted and in group M (n = 50) real-time US-guided SAB was administered. The number of needle attempts for a successful SAB was the primary outcome. The secondary outcomes included successful SAB in first attempt, time taken to perform SAB and patients’ satisfaction. RESULTS: The number of attempts for SAB were (mean ± standard deviation = 1.05 ± 0.35, 1.00 ± 0.28, 1.03 ± 0.26) in groups L, P and M, respectively (P = 0.436). The SAB was successful in the first attempt in 82%, 82% and 80% in groups L, P and M, respectively (P = 0.207). The time taken for the successful SAB was more in group M as compared to groups L and P (groups L and M, P = 0.045 and groups P and M, P = 0.004). The patients’ satisfaction score was comparable. CONCLUSION: Real-time US guidance for spinal anaesthesia resulted in needle attempts comparable to landmark and preprocedural US-assisted SAB in patients with a normal spine. The time required for the completion of the block was more in real-time US-guided SAB.
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spelling pubmed-91166332022-05-19 Comparative evaluation of three techniques for paramedian subarachnoid block: Point-of-care preprocedural ultrasound assisted, real-time ultrasound guided and landmark based Bhardwaj, Deepak Thakur, Lokesh Sharma, Shalini Rana, Shelly Gupta, Bhanu Sharma, Charu Indian J Anaesth Original Article BACKGROUND AND AIMS: Preprocedural ultrasound (US) assisted and real-time US-guided subarachnoid block (SAB) are useful adjuncts for successful SAB. This study compared the feasibility and efficacy of real-time US-guided SAB with preprocedural US-assisted and landmark-based SAB using paramedian approach. METHODS: The study enroled 150 American Society of Anesthesiologists I and II patients, aged 20–65 years, scheduled for lower limb orthopaedic surgery under SAB. In group L (n = 50), the patients underwent landmark-guided SAB utilising paramedian approach. In group P (n = 50), preprocedural US-assisted SAB was instituted and in group M (n = 50) real-time US-guided SAB was administered. The number of needle attempts for a successful SAB was the primary outcome. The secondary outcomes included successful SAB in first attempt, time taken to perform SAB and patients’ satisfaction. RESULTS: The number of attempts for SAB were (mean ± standard deviation = 1.05 ± 0.35, 1.00 ± 0.28, 1.03 ± 0.26) in groups L, P and M, respectively (P = 0.436). The SAB was successful in the first attempt in 82%, 82% and 80% in groups L, P and M, respectively (P = 0.207). The time taken for the successful SAB was more in group M as compared to groups L and P (groups L and M, P = 0.045 and groups P and M, P = 0.004). The patients’ satisfaction score was comparable. CONCLUSION: Real-time US guidance for spinal anaesthesia resulted in needle attempts comparable to landmark and preprocedural US-assisted SAB in patients with a normal spine. The time required for the completion of the block was more in real-time US-guided SAB. Wolters Kluwer - Medknow 2022-03 2022-03-25 /pmc/articles/PMC9116633/ /pubmed/35601040 http://dx.doi.org/10.4103/ija.ija_373_21 Text en Copyright: © 2022 Indian Journal of Anaesthesia https://creativecommons.org/licenses/by-nc-sa/4.0/This is an open access journal, and articles are distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as appropriate credit is given and the new creations are licensed under the identical terms.
spellingShingle Original Article
Bhardwaj, Deepak
Thakur, Lokesh
Sharma, Shalini
Rana, Shelly
Gupta, Bhanu
Sharma, Charu
Comparative evaluation of three techniques for paramedian subarachnoid block: Point-of-care preprocedural ultrasound assisted, real-time ultrasound guided and landmark based
title Comparative evaluation of three techniques for paramedian subarachnoid block: Point-of-care preprocedural ultrasound assisted, real-time ultrasound guided and landmark based
title_full Comparative evaluation of three techniques for paramedian subarachnoid block: Point-of-care preprocedural ultrasound assisted, real-time ultrasound guided and landmark based
title_fullStr Comparative evaluation of three techniques for paramedian subarachnoid block: Point-of-care preprocedural ultrasound assisted, real-time ultrasound guided and landmark based
title_full_unstemmed Comparative evaluation of three techniques for paramedian subarachnoid block: Point-of-care preprocedural ultrasound assisted, real-time ultrasound guided and landmark based
title_short Comparative evaluation of three techniques for paramedian subarachnoid block: Point-of-care preprocedural ultrasound assisted, real-time ultrasound guided and landmark based
title_sort comparative evaluation of three techniques for paramedian subarachnoid block: point-of-care preprocedural ultrasound assisted, real-time ultrasound guided and landmark based
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9116633/
https://www.ncbi.nlm.nih.gov/pubmed/35601040
http://dx.doi.org/10.4103/ija.ija_373_21
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