Ultrasound-Guided Versus Landmark Technique for Spinal Anesthesia: A Comparative Study of Success Rate, Procedure Time, and Complications

Abstract

Background: Spinal anesthesia is extensively applied in lower abdominal and lower limb surgery; nonetheless, the traditional landmark technique is linked to the varying success rates and complications. Ultrasound guidance has been brought out as a possible tool of enhancing accuracy and clinical results.

Aim: To compare the ultrasound-guided with the landmark methods of spinal anesthesia in terms of the first-attempt success rate, duration of the procedure, and complications.

Methods: It was a prospective comparative study that was carried out over a period of one year in the Medical Research Teaching Hospital. One hundred and twenty adult patients who were to undergo elective surgeries under spinal anesthesia were divided equally between two groups; ultrasound-guided (n = 60) and landmark technique (n = 60). The first-attempt success rate was used as the primary outcome, and other secondary outcomes were the procedure time, the number of attempts, as well as the complications. Data analysis was done with SPSS 28 and p = 0.05 was used as the level of significance.

Findings: The ultrasound group had a much higher success rate on the first attempt than the landmark group (86.7% vs 63.3% p = 0.003). The time spent at the procedure was also a lot less in the ultrasound group (3.8 +1.2 minutes vs 6.1 +2.0 minutes, p = 0.001). Also, ultrasound group experienced fewer needle attempts and reduced cases of complications, such as paresthesia, bloody tap, and failed block (p < 0.05).

Conclusion: Ultrasound-guided spinal anesthesia is better and safer in comparison to the traditional landmark method, with a better success rate, shorter duration of a procedure, and less number of complications. It is advisable to incorporate it into the normal practice of anesthetic practice in case of resources.