COMPARISON OF MEDIAN AND PARAMEDIAN TECHNIQUES OF SPINAL ANAESTHESIA

Abstract

Objective: To compare median and paramedian technique of spinal anaesthesia in terms of success rate, number of attempts, paresthesia, bloody tap and length of needle.
Study Design: Comparative cross-sectional study.
Place and Duration of Study: Department of Anaesthesia and Intensive care PNS Shifa Karachi over duration of one year from March 2007 to Feb 2008.
Patients and Methods: This was a comparative cross-sectional study and 100 patients undergoing spinal anaesthesia for lower abdominal and lower limb surgeries were included. Hundred patients were divided into two separate groups. Group I was given spinal anaesthesia with median approach and Group II was given spinal anaesthesia with paramedian approach. In both the groups the patients were divided using non probability convenience sampling and patients were blind to the choice of technique of spinal anaesthesia used, however consent was obtained from every patient to be included in study.
Results: The success rate of median approach was found to be 84%, with the first attempt success rate of 48%. Paresthesia was felt by 38% of patients and incidence of bloody tap was 6%. Length of needle required most of the time was between 4-6 cms. The success rate of paramedian approach was found to be 96%, with first attempt success rate of 70%. Paresthesia was felt by 20% of patients and incidence of bloody tap was 12%. Most of the time length of needle required was between 6-8 cms.
Conclusion: Paramedian approach is associated with higher success rate with lesser number of attempts and decreased incidence of paresthesia.