Comparison of Efficacy of Real-Time Ultrasound Versus Preprocedural Ultrasound on Success Rate of Spinal Anesthesia in Elderly Patients Undergoing Elective Infraumbilical Surgeries: A Randomized Control Study
Mutukundu Hari Pooja, Chinnappan Kuppuswamy Swetha RamaniAbstract
Background:
Spinal anesthesia is suitable for the elderly, but the traditional landmark-based technique is difficult to perform. We aimed to compare the success rates of real-time (R) and preprocedural (P) ultrasound techniques for paramedian spinal anesthesia in elderly patients.
Materials and Methods:
A prospective, randomized controlled study was conducted in 74 patients aged ≥65 years with American Society of Anesthesiologists Grade II/III who were scheduled for elective infraumbilical surgeries. The participants were randomly allocated into two groups, Group R and Group P. Block parameters and hemodynamic data were collected. Statistical analysis was performed using IBM Statistical Package for the Social Sciences, version 21.0.
Results:
The first-attempt success rates were 59.5% and 64.9% in Group R and Group P, respectively (
Conclusion:
Both real-time and preprocedural ultrasound are useful adjuncts for spinal anesthesia in the elderly. The first-attempt success rate was higher with the preprocedural technique, though not statistically significant. The real-time technique reduced procedural time and required fewer needle passes, while the preprocedural technique was associated with lower procedural difficulty scores. Both techniques appear feasible, and the selection of the ultrasound technique should be guided by patient factors and operator expertise.