Ultrasound guidance for subarachnoid block in parturient [Gebede lomber ultrasonografi̇ eçli̇ǧi̇nde subaraknoi̇d blok]

Objective: subarachnoid blocks have become the technique of choice for elective cesarean sections. current techniques to identfy a safe interspace have limitations. in this study,we assessed prepuncture lumbar ultrasound scanning as a tool for estimating the depth to the subdural space and determining the optimal insertion point in parturients. method: after approval by the ethics committe and written informed consent,asa i-ii,sixty-eight term pregnant women scheduled to receive subarachnoid blockade for caesarean section were included in the study. with the patients in the sitting position,the same anesthesiologist performed a lumbar spine ultrasound scan to identfy the l4-l5 interspace. the intercristal line (tuffier's line) were assessed by ultrasound to detect its clinical level. the distances from the skin to the ligamentum flavum and from skin to the subdural space (ultrasound depth,ud) were measured in the paramedian and transverse planes. results: there was a high correlation between the ultrasound depth and the needle depth (nd) (r= 0.71 p< 0.001). the mean ultrasound depth was 5.3 cm,whereas the needle depth was 6.1 cm. successful identification of the subarachnoid space was accomplished in 92.6% of the cases. first attempt success rate was 83.7%. conclusion: we found a good correlation between the ultrasound depth and the needle depth. this suggests that ultrasound can be a reliable guide to facilitate subarachnoid needle placement in parturients.