Gayathri B, Swetha Ramani C K, Urkavalan Karthika, Pushparani A, Rajendran A
Department of Anaesthesiology, SRM Medical College Hospital and Research Centre, Chengalpattu, Tamil Nadu, India.
Department of Anaesthesiology, Government Dharmapuri Medical College Hospital, Dharmapuri, Tamil Nadu, India.
J Anaesthesiol Clin Pharmacol. 2021 Apr-Jun;37(2):205-209. doi: 10.4103/joacp.JOACP_35_20. Epub 2021 Jul 15.
Spinal anesthesia is the regional technique preferred for cesarean section and is usually administered using the traditional landmark technique. Ultrasonography of the spine appears to be helpful in locating the puncture site and increasing the success rate. The primary objective of this study was to assess the use of ultrasonogram in locating the lumbar interspinous space for spinal anesthesia in laboring parturients brought for elective cesarean section.
Sixty parturients scheduled to undergo elective cesarean section under spinal anesthesia were included in this prospective randomized controlled trial, after obtaining the institutional ethical clearance. In Group I, 30 patients received spinal anesthesia by landmark technique and in Group II, 30 patients underwent ultrasound-guided spinal anesthesia. The statistical analysis was done using SPSS software version 17 (SPSS Inc., Chicago, Illinois, USA) for Microsoft windows.
The time taken for spinal in Group I was longer than in Group II (62 ± 18s; 41 ± 11s; = 0.0001). The number of attempts of needle insertion was significantly less in Group II (group I 1.86 ± 1.04: group II 1.06 ± 0.25). However, the total preparation time (28 8.30 ± 92 vs 804.73 ± 77; = 0.0001) was more in the ultrasound-guided than in the landmark group. The patients had better satisfaction in group II.
Preprocedural ultrasound is a useful tool for successful lumbar puncture in parturients as it minimizes the number of attempts of needle insertion and provides better patient satisfaction.
脊髓麻醉是剖宫产首选的区域麻醉技术，通常采用传统的体表标志技术进行操作。脊柱超声检查似乎有助于定位穿刺点并提高成功率。本研究的主要目的是评估超声检查在为择期剖宫产的临产产妇进行脊髓麻醉时定位腰椎棘突间隙的应用。
在获得机构伦理批准后，本前瞻性随机对照试验纳入了60例计划在脊髓麻醉下进行择期剖宫产的产妇。第一组30例患者采用体表标志技术进行脊髓麻醉，第二组30例患者接受超声引导下的脊髓麻醉。使用适用于微软视窗系统的SPSS软件17版（美国伊利诺伊州芝加哥市SPSS公司）进行统计分析。
第一组脊髓麻醉所需时间比第二组长（62±18秒；41±11秒；P = 0.0001）。第二组的穿刺针插入尝试次数明显更少（第一组1.86±1.04；第二组1.06±0.25）。然而，超声引导组的总准备时间（288.30±92秒对804.73±77秒；P = 0.0001）比体表标志组更长。第二组患者的满意度更高。
术前超声检查是产妇成功进行腰椎穿刺的有用工具，因为它能减少穿刺针插入的尝试次数并提高患者满意度。
