PREDICTING DIFFICULTY SCORE FOR SPINAL ANAESTHESIA IN PATIENTS UNDERGOING LOWER LIMB AND LOWER ABDOMINAL SURGERY
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Keywords
Predicting Difficulty Score, Spinal Anaesthesia, BMI
Abstract
Background: In this study we wanted to investigate as to whether there was any significant relationship between spinous process abnormalities and BMI as predictors of the difficulty score for spinal anaesthesia.
Methods: This was a prospective randomised study conducted among in-patients of TSHRC scheduled for lower limb and lower abdominal surgery under spinal anaesthesia. 96 patients aged 18 to 75 years undergoing lower abdominal and lower limb surgeries belonging to ASA I and ASA II were included in the study.
Results: The majority of research participants (62.5%) had normal BMIs. 12.5 percent had a BMI of ≥30.0, while 18.8% had a BMI of 25.0–29.9. The majority of the patients-73 individuals, or 76% had easy spinal anaesthesia. 18 patients (19%) had quite difficult spinal anaesthesia performed. In the moderate group, the needle needed to be redirected in the same location in 12 patients (13%) and a new effort was performed in a second space in 6 patients (6%). Five patients were found to have difficult spinal anaesthesia, four of them attempted in the second space with redirection and one patient (1%) attempted it in the third space. 53 patients or 55% of the total had visible spinal processes, while about 7 patients or 7% of the total had invisible and impalpable spinal processes. 36 patients (38%) had a spinal process that could be felt.
Conclusion: A BMI of >30 and an impalpable and invisible spinous process are risk factors for problematic spinal anaesthesia. Patients with a visibly perceptible spinous process and a BMI of 25–30 provide a moderate challenge for spinal anaesthesia.
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Dr Archana Mhatre
Professor & HOD, Department of Anaesthesiology, Terna Medical College, Nerul West, Navi Mumbai, Maharashtra, India.
Dr. Sunanda Panigrahi
Associate Professor, Department of Anaesthesiology, D.Y. Patil Medical College, Nerul, Navi Mumbai, Maharashtra, India.
Dr. Madhuri Dhabarde
Professor, Department of Anaesthesiology, Terna Medical College, Nerul West, Navi Mumbai, Maharashtra, India.
Dr. Sunita Nayak
Assistant Professor, Department of Anaesthesiology, Terna Medical College, Nerul West, Navi Mumbai, Maharashtra, India.
Dr. Pulla Sharath Chandra
Junior Resident, Department of Anaesthesiology, D.Y. Patil Medical College, Nerul, Navi Mumbai, Maharashtra, India.
Dr. Sunkara Reddy Vinay
Junior Resident, Department of Anaesthesiology, D.Y. Patil Medical College, Nerul, Navi Mumbai, Maharashtra, India.