Comparative study of midline versus paramedian approach of spinal block in elderly.

Abstract

Objective: To compare the efficacy of paramedian and midline approach for spinal block in elderly, in terms of success rate and number of attempts required by either approach. Study Design: Randomized Controlled Trial. Setting: Department of Anaesthesia, Madina Teaching Hospital Faisalabad. Period: January 2018 to December 2019. Material & Method: 120 elderly ASA I-III patients scheduled to undergo lower abdominal or limbs; general or orthopaedic surgery were randomly divided into two equal groups A and B of sixty patients. Patients were assigned into groups by lottery method. Group A patients were supposed to receive spinal block by midline approach while group B patients were planned to receive spinal block by paramedian approach. Results: It was observed that success rate was significantly high in group B, 98.3% as compared to group A, 80%, (p value 0.001). The number of attempts were significantly less in group B in comparison to group A (p-value 0.0001). Conclusion: The paramedian approach for spinal block in elderly patient’s offers ease of administration and a higher success rate as compared to midline approach.