Accuracy of Manual Palpation vs Ultrasound for Spinal Anesthesia

Assessment of the Accuracy of the Manual Palpation of Surface Landmarks Versus Ultrasound for Identification of the Correct Intervertebral Space for Spinal Anesthesia in Children Less Than 1 Year of Age

Although the current standard for lumbar puncture and spinal anesthesia is the use of manual palpation of surface landmarks to identify the correct interspace, performance of the procedure at too high of a level may increase the incidence of adverse effects. The current study will evaluate the efficacy of ultrasound in identifying the correct intervertebral space for lumbar puncture thereby improving the safety of the procedure.

Inclusion Criteria:

• Patients less than 1 year of age scheduled for spinal anesthesia for elective lower abdominal, urologic, or lower extremity surgery at Nationwide Children's Hospital

Exclusion Criteria:

• Parents unwilling for their children to undergo spinal anesthesia for surgery.
• Children with known spinal anomalies including sacral dimple.
• Children with coagulation abnormalities or receiving anticoagulation which precludes the use of spinal anesthesia.
• Children with superficial or deep infections over the spine which precludes the use of spinal anesthesia.