Landmark Versus Ultrasongraphy Guided Spinal Anesthesia in Lower Abdominal Surgeries in Cancer Patients: a Randomized Controlled Trial

Assiut University

Status: Not yet enrolling

Conditions: Cancer Surgery

Treatments: Procedure: spinal anesthesia

Study type: Interventional

Funder types: Other

Identifiers

NCT06707571

landmark VS US guided

Details and patient eligibility

About

Spinal anesthesia is a commonly employed technique for lower abdominal surgeries, providing effective anesthesia and analgesia with minimal systemic effects. In cancer patients undergoing such procedures, careful consideration of anesthetic techniques is crucial, given their often-compromised physiological state and the need to minimize postoperative complications. Two approaches to administering spinal anesthesia are Ultrasound (US)-guided and the traditional landmark-based technique.

the aim of the study :To evaluate the efficacy, safety and feasibility of US-guided spinal anesthesia versus the landmark-based technique in cancer patients undergoing lower abdominal surgery.

Full description

The traditional landmark method relies on palpating anatomical structures, such as the iliac crests and spinal processes, to guide needle insertion. Although widely used, it can be challenging in patients with anatomical variations, obesity, or previous surgeries, potentially leading to multiple attempts, increased patient discomfort, or complications. On the other hand, Ultrasound (US) imaging has become an increasingly popular tool among anesthesiologists to guide neuraxial blockade. US-guided spinal anesthesia provides real-time visualization of the relevant anatomy, including the spinal canal, ligaments, and surrounding tissues, enabling more accurate needle placement. This technique has gained attention for its potential to improve success rates, reduce complications, and enhance patient comfort, particularly in complex cases such as cancer patients, where precision is vital.

By examining factors such as procedural success rates, patient comfort, complication rates, and overall outcomes, we can better understand the role of ultrasound guidance in optimizing anesthetic care for this vulnerable patient population.

Enrollment: 52 estimated patients

Sex: All

Ages: 18+ years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• Age >18 years old
• Both sex
• patients with a body mass index (BMI) of 18-40 kg/m2
• American Society of Anesthesiologists (ASA) physical status classification of I to III.

Exclusion criteria

• • Patients have a contraindication for regional anesthesia, e.g. coagulopathy.

  • Failed or unsatisfactory intrathecal block.
  • Patients with known hypersensitivity to amide local anesthetics.
  • Local injection site infection or spinal deformity.
  • Severe hypotension.
  • Space occupying lesions of the brain.
  • Hypovolemia.
  • Pregnancy.

Trial design

Primary purpose: Treatment

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: Quadruple Blind

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52 participants in 2 patient groups

Landmark Group

Experimental group

Description:

patients will receive spinal anesthesia using the surface landmark-guided

Treatment:

Procedure: spinal anesthesia

Procedure: spinal anesthesia

Ultrasonography Group

Experimental group

Description:

patients will receive spinal anesthesia after us-assisted technique

Treatment:

Procedure: spinal anesthesia

Procedure: spinal anesthesia