ULTRASOUND-GUIDED NEURAXIAL ANAESTHESIA VERSUS LANDMARK TECHNIQUE: COMPARISON OF FIRST-PASS SUCCESS, NUMBER OF ATTEMPTS AND PATIENT SATISFACTION

Background: Neuraxial anaesthesia is commonly performed using conventional anatomical landmarks; however,identification of the appropriate intervertebral space and needle insertion point may be difficult in some patients. Ultrasoundprovides additional anatomical information and may improve the technical performance of neuraxial procedures. This studycompared ultrasound-guided neuraxial anaesthesia with the conventional landmark technique with respect to first-pass success,number of needle attempts, and patient satisfaction. Materials and Methods: A prospective, randomized comparative studywas conducted among 200 adult patients scheduled for elective surgery under neuraxial anaesthesia. Patients were randomlyallocated into two groups of 100 each. Group U received preprocedural ultrasound-guided neuraxial anaesthesia, while GroupL underwent conventional landmark-guided neuraxial anaesthesia. First-pass success, number of needle attempts, and patientsatisfaction using a 5-point Likert scale were assessed. Results: First-pass success was significantly higher in the ultrasoundgroup than in the landmark group (88.0% vs 70.0%; p=0.002). The mean number of needle attempts was significantly lowerwith ultrasound guidance (1.15 ± 0.42 vs 1.45 ± 0.71; p<0.001). Patient satisfaction was also significantly higher in theultrasound group, with mean scores of 4.46 ± 0.70 and 4.13 ± 0.91, respectively (p=0.005). Conclusion: Ultrasound-guidedneuraxial anaesthesia demonstrated higher first-pass success, fewer needle attempts, and greater patient satisfaction comparedwith the conventional landmark technique.