Spinal anesthesia is a straightforward and reliable technique frequently employed in lower body surgeries, achieving adequate surgical conditions through the injection of a small amount of local anesthetic (LA) into the intrathecal space . One advantage of spinal anesthesia over general anesthesia is reduced exposure to potentially depressant drugs . However, inadequate spinal spread can result in pain and discomfort for patients and complicate surgical procedures . Consequently, anesthesiologists encounter the challenge of attaining the proper spread of spinal anesthesia for subumbilical herniorrhaphy due to individual anthropometric variations .

Approximately 25 factors have been identified that affect the spread of spinal anesthesia in the subarachnoid space for a given dose of LA . Variables that are both practically obtainable and predictive of spinal anesthesia spread can aid anesthesiologists in anticipating the extent of the block. Among the most studied factors are patient characteristics, injection techniques, patient posture, and the baricity of the LA .

Research has examined various patient variables affecting spinal anesthesia spread, including age , weight , height , gender, patient position, BMI , vertebral column length (VCL), and abdominal circumference . Body morphometrics such as the hip-shoulder width ratio (HSWR) have garnered attention for their potential impact on the distribution of anesthetic agents within the intrathecal space . Despite the well-established influence of factors like age, weight, and spinal anatomy, the specific role of HSWR in the outcomes of intrathecal anesthesia remains underexplored this study aim to To evaluate the effect of hip/shoulder-width ratio (HSWR) on sensory blockade level after intrathecal anesthesia for adult patients undergoing subumblical herniorraphy

Spinal anesthesia is a straightforward and reliable technique frequently employed in lower body surgeries, achieving adequate surgical conditions through the injection of a small amount of local anesthetic (LA) into the intrathecal space . One advantage of spinal anesthesia over general anesthesia is reduced exposure to potentially depressant drugs . However, inadequate spinal spread can result in pain and discomfort for patients and complicate surgical procedures . Consequently, anesthesiologists encounter the challenge of attaining the proper spread of spinal anesthesia for subumbilical herniorrhaphy due to individual anthropometric variations .

Approximately 25 factors have been identified that affect the spread of spinal anesthesia in the subarachnoid space for a given dose of LA . Variables that are both practically obtainable and predictive of spinal anesthesia spread can aid anesthesiologists in anticipating the extent of the block. Among the most studied factors are patient characteristics, injection techniques, patient posture, and the baricity of the LA .

Research has examined various patient variables affecting spinal anesthesia spread, including age , weight , height , gender, patient position, BMI , vertebral column length (VCL), and abdominal circumference . Body morphometrics such as the hip-shoulder width ratio (HSWR) have garnered attention for their potential impact on the distribution of anesthetic agents within the intrathecal space . Despite the well-established influence of factors like age, weight, and spinal anatomy, the specific role of HSWR in the outcomes of intrathecal anesthesia remains underexplored

Inclusion Criteria:

• Age 20 - 50 years old
• Both sexes
• Patients who are in risk-scoring groups I-II of the American Society of Anesthesiologists (ASA)
• Elective subumblical herniorraphy under intrathecal anesthesia

Exclusion Criteria:

• • Patient refusal

  • Patients have a contraindication for regional anesthesia, e.g. coagulopathy.
  • Failed or unsatisfactory intrathecal block.
  • Patients have a central nervous system disease (mental retardation, non-cooperated speech disorder, or psychiatric disease).
  • Patients who are under 150 cm or over 185 cm in height, or BMI >40.
  • Patients have experienced an operation lasting more than 2 h.
  • Patients with known hypersensitivity to amide local anesthetics.
  • Local injection site infection or spinal deformity.

patients subjected to subumblical herniorraphy