Efficacy of Ultrasound-guided versus Palpation-guided Techniques in Spinal Anesthesia: A Randomized Controlled Trial

Objective: This study aims to assess and compare the effectiveness of spinal anesthesia administered through traditional palpation and ultrasound (US) guidance by analyzing the precision of needle placement, procedural success, patient satisfaction, and complication rates. Method:A prospective, randomized clinical trial was conducted involving 135 patients (American Society of Anesthesiologists I-III) scheduled for lower limb surgery.Participants were randomized into two groups: The palpation group (n=65) and the US-guided group (n=66).Parameters including the accuracy of needle entry point, the number of attempts required to obtain cerebrospinal fluid (CSF), patient satisfaction levels, and the incidence of complications were documented and evaluated. Results:The success rate of CSF identification on the first attempt was 83.0% in the palpation group and 89.3% in the US guided group (p=0.6).While 28.4% of the spinal punctures in the palpation group were conducted outside the intended intervertebral space, all procedures in the US guided group were accurately localized (p<0.05).There were no statistically significant differences between the groups concerning the total number of attempts, complication occurrence, or patient satisfaction (p>0.05).However, among patients with a body mass index exceeding 30, the US guided group demonstrated a significantly higher success rate and required fewer attempts compared to the palpation group (p<0.01). Conclusion: US imaging enhances the accuracy of spinal level determination, although both techniques yield comparable overallAma: Bu alma, spinal anestezinin geleneksel palpasyon ve ultrason (US) rehberlii ile uygulanmasnn etkinliini; ine yerletirme doruluu, ilem baars, hasta memnuniyeti ve komplikasyon oranlar asndan analiz ederek deerlendirmeyi ve karlatrmay amalamaktadr.Yntem: Alt ekstremite cerrahisi planlanan, Amerikan Anestezistler Dernei I-III snfnda 135 hastann yer ald prospektif, randomize bir klinik alma yrtld.Katlmclar iki gruba randomize edildi: palpasyon grubu (n=65) ve US rehberli grup (n=66).ne giri noktasnn doruluu, beyin omurilik svsna (BOS) ulamak iin gereken deneme says, hasta memnuniyet dzeyleri ve komplikasyon insidans gibi parametreler belgelenip deerlendirildi.Bulgular: lk denemede BOS elde edilme baars, palpasyon grubunda %83,0, US rehberli grubunda ise %89,3 olarak bulundu (p=0,6).Palpasyon grubunda spinal ponksiyonlarn %28,4' hedeflenen intervertebral araln dnda gerekletirilirken, US rehberli gruptaki tm ilemler doru lokalize edilmitir (p<0,05).Toplam deneme says, komplikasyon insidans ve hasta memnuniyeti asndan gruplar arasnda istatistiksel olarak anlaml bir fark gzlenmedi (p>0,05).Ancak, beden kitle indeksi 30'un zerinde olan hastalar arasnda, US rehberli grupta anlaml derecede daha yksek baar oran elde edilmi ve daha az giriim gerekmitir (p<0,01). Sonu: US