Reduction of the Technical Difficulties Associated with Spinal Anesthesia among Elderly Patients with Difficult Anatomies and Fractures

Background Spinal anesthesia is classified as among the most reliable types of regional block methods. Multiple needle attempts result in complications, including post-dural puncture headache, spinal hematoma, permanent neurological damage, and neurological trauma. Some methods developed are landmark-assisted and ultrasonography-guided (USG) for neuraxial spinal anesthesia. The aim or objective is to implement the use of USG to help manage the technical difficulties with the placement of the spinal block among the elderly suffering from fractures and those with complex anatomies. Method The method is a quality improvement project that began with a comprehensive literature review comparing USG and landmark-assisted use for spinal anesthesia. This review was crucial in establishing the effectiveness of USG and providing a solid foundation for our project. The quality improvement adopted the quasi-experimental one-group, pre-/post-intervention design, where the interventional outcome of interest is measured two times before and after exposing the group to the intervention. An email was sent to the anesthesia providers to recruit the participants and confirm their inclusion in the QI project. A MEMO was placed on the notice boards of the surgical and emergency departments. Data was collected using the patient satisfaction survey rating the level of service they received. Numerical data were collected, including the technical difficulties involved, such as first-time insertions, and analyzed for pre- and post-intervention to determine if there have been any improvements.