Does Ultrasound Guidance Improve Time to Perform a Spinal or Number of Attempts in Obese Patients?

Does Ultrasound Guidance Improve Time to Perform a Spinal or Number of Attempts in Obese Patients? A Randomized Controlled Study.

Spinal anesthesia depends on being able to locate physical landmarks on a patient's body. In obese patients, the commonly used landmarks may be difficult or even impossible to feel. In addition, the spine can be hidden beneath a layer of fatty tissue.

Ultrasound is useful for finding the correct injection site in pregnant patients, but the usefulness of ultrasound has not been adequately evaluated in non-pregnant patients. The potential benefits for obese patients from the use of ultrasound include shortening the duration of the procedure, increasing patient comfort, decreasing the total number of attempts, and aiding in the choice of appropriate needle length for the patient.

The investigators hypothesize that there is no difference in time to perform a spinal anesthetic when landmarking with ultrasound as compared to tactile landmarking in patients with BMI > 35.

Inclusion Criteria:

• Patients undergoing surgeries amenable to spinal anesthetic
• BMI >35
• between the ages of 18-85

Exclusion Criteria:

• Patients with known spinal disease or previous spinal surgery
• Pregnant patients
• Patients requiring emergent surgeries
• Patients in positions other than sitting during neuroaxial anesthesia
• Patients with contraindications to neuroaxial anesthesia