Comparison Between Palpatory and Preprocedural Ultrasound Guided Techniques on Performance of Spinal Anesthesia
Comparison Between Palpatory and Preprocedural Ultrasound Guided Techniques on Performance of Spinal Anesthesia
Pre-procedural ultrasound for Spinal & Epidural anesthesia is now being increasingly
 performed worldwide. Pre-procedural ultrasound assessment of the spine has been shown to
 facilitate the placement of epidural anesthesia in pregnant women, diagnostic lumbar
 punctures, performance of spinal anesthesia in non-obstetric patients and accurate
 identification of the interspace at which the puncture is being performed. This is especially
 important during spinal anesthesia, where puncture below the ending of the spinal cord is
 recommended for safety.

 The purpose of this study is to compare the performance of spinal anesthesia between the
 pre-procedural ultrasound assessment of the spine and the traditional palpatory technique, in
 term pregnant women undergoing elective cesarean delivery. Furthermore, we aim to describe
 sonoanatomic features of the spine that could predict the ease of insertion of spinal
 anesthesia in that patient population.

 We hypothesize that in term pregnant women undergoing elective cesarean delivery,
 pre-procedural ultrasound assessment of the spine will improve the success rate of spinal
 anesthesia at first attempt, compared to the traditional palpatory technique.
Inclusion Criteria:

 -  Pregnant patients scheduled to receive spinal anesthesia for elective cesarean
 sections

 -  ASA physical status 1 - 3

 -  Written informed consent

 -  Gestational age ≥ 37 weeks.

 Exclusion Criteria:

 -  Patient's refusal.

 -  Body mass index ≥ 45

 -  Patient with marked spinal bony deformity (Severe scoliosis on visual inspection and
 previous spinal instrumentation).