Dr. Vimal Pradeep,
BACKGROUND Spinal anaesthesia is a procedure commonly performed by the anaesthesiologist. Various reasons can lead to a difficulty in performing a lumbar puncture, leading to multiple attempts, thereby increasing chances of complications. Quality of anatomical landmarks is one of the predictors of successful performance of subarachnoid block. MATERIALS AND METHODS 245 patients scheduled for surgery under spinal anaesthesia were enrolled. Interspinous gap and spinous process width were the measured study variables. Patients were classified as either having easy access to subarachnoid space or not, as the outcome variable. Association between these was measured using Chi-square test. RESULTS Confirm that there is obvious association between the ease of access to the subarachnoid space and the interspinous gap and the spinous process width. On further analysis, after dividing the study population based on gender, it was found that the association between the study variables and outcome variable was statistically insignificant in the female population. CONCLUSION Techniques based on surface anatomy of landmarks provide only less than 70% first attempt success rate in performing subarachnoid block. Interspinous gap measured from surface landmarks by palpation correlates consistently with ease of access to subarachnoid space. Imaging confirmation of the palpated measurements for further validation may be considered in future studies.
