Median and Paramedian Approach in Spinal Anesthesia

Trabzon Kanuni Education and Research Hospital

Status: Completed

Conditions: Geriatric Patients; Efficacy, Self

Treatments: Procedure: paramedian approach; Procedure: median approach

Study type: Interventional

Funder types: Other

Identifiers

NCT03750877

+90

Details and patient eligibility

About

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.

Full description

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.

Enrollment: 100 patients

Sex: All

Ages: 70+ years old

Volunteers: No Healthy Volunteers

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

Trial design

Primary purpose: Other

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: Single Blind

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100 participants in 2 patient groups

median approach

Active Comparator group

Description:

Spinal anesthesia will be performed with a conventional median approach

Treatment:

Procedure: paramedian approach

Procedure: median approach

paramedian approach

Active Comparator group

Description:

Spinal anesthesia will be applied with a paramedian approach.

Treatment:

Procedure: paramedian approach

Procedure: median approach