Median and Paramedian Approach in Spinal Anesthesia

Trabzon Kanuni Education and Research Hospital100 enrolled

Overview

Spinal anesthesia (SA) is frequently used as anesthesia in many surgeries such as lower abdominal, inguinal, urogenital, rectal and lower extremities. Conventional median approach (MA) is preferred more frequently, although MA or paramedian approach (PA) is used in SA. Especially in geriatric patients due to degenerative changes Although we are told that degenerative changes are less affected in PA during SA in the geriatric age group, few studies have been conducted on the subject and we aimed to evaluate the superiority of the two methods.

In our study, 100 cases were planned to be evaluated prospectively. Patients scheduled for surgery under spinal anesthesia will undergo routine spinal preparation. After routine motorization, patients will be treated with MA or PA. MA will be performed in a conventional manner and PA will be performed by adding 1 cm lateral and 1 cm caudal from the planned vertebral space to 10-15 degree medial and cephal. If one of the patients with MA or PA fails, despite three attempts, the other method will be tried by another specialist. If the procedure fails or there are not enough blocks, a different anesthesia method will be applied. The data of the patients included in the study were evaluated by a different researcher other than the SA physician; demographic data of the cases, type of operation, MA or PA in SA and the number of repeated attempts / trials for the procedure will be evaluated.

Study Type

INTERVENTIONAL

Allocation

RANDOMIZED

Purpose

OTHER

Masking

SINGLE

Enrollment

100

Conditions

Geriatric Patients Efficacy, Self

Interventions

median approachPROCEDURE

spinal anesthesia with median approach; is the known classical method and it is aimed to reach the spinal area from the middle line.

paramedian approachPROCEDURE

In spinal anesthesia with a paramedian approach, 1 cm lateral and 1 cm caudal to reach the spinal area.

Eligibility

Sex: ALLMin age: 70 Years

Medical Language ↔ Plain English

Inclusion Criteria: * Patients older than 70 years * elective surgery under spinal anesthesia * those who agreed to participate in the study * Those with American Society of Anesthesiologists (ASA) 1-3 Exclusion Criteria: * who use opioid or other non-steroidal anti-inflammatory drugs regularly * who are allergic to a drug used in the study * had contraindications for spinal anesthesia, * drug addiction * obese patients (Body Mass Index ≥ 35) * migraine and chronic headache * Spinal anesthesia can not be performed in more than 3 trials, but passed to the general anesthesia * those who do not agree to participate in the study

Locations (1)

TRABZON

Yomra, Turkey (Türkiye)

Outcomes

Primary Outcomes

spinal needle touches the spinal bone

The ability of getting a successful spinal anesthesia with a single skin puncture and no needle redirection.

Time frame: during the procedure of spinal anesthesia

Number of repeated attempts (attempts):

The ability of getting a successful spinal anesthesia with a single skin puncture and no needle redirection.

Time frame: during the procedure of spinal anesthesia

duration of procedure

In spinal anesthesia, the time to reach the skin and the spinal area will be evaluated.

Time frame: during the procedure of spinal anesthesia

Secondary Outcomes

success rate of spinal needle insertion

The ability of getting a successful spinal anesthesia with a single skin puncture regardless of needle redirection.

Time frame: during the procedure of spinal anesthesia

Complications of the procedure

complications of spinal anesthesia will be evaluated, during spinal anesthesia and during the first week

Time frame: during the procedure of spinal anesthesia and 1 week after spinal anesthesia

Data from ClinicalTrials.gov

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