Ultrasound-assisted Spinal Anesthesia in Midline Versus Paramedian Approach in Adult Orthopedic Surgery

Ultrasound-assisted Spinal Anesthesia in Midline Versus Paramedian Approach in Adult Orthopedic Surgery

This study aims to compare between the two methods (midline and paramedian approach of spinal anesthesia guided by ultrasound) by the number of needle passes required to successful dural puncture.

Inclusion Criteria:

• Patients will perform orthopedic surgery
• Physical state I or II according to ASA classification
• Age between (18 - 50 )
• Body mass index less than 30

Exclusion Criteria:

• Patient refusal .
• Local infection at the puncture site .
• Allergy to any of the drugs to be administrated .
• Old age patients
• Obese patients
• Previous spinal surgery .
• Spinal stenosis .
• Multiple sclerosis .
• Coagulopathy.
• Hypovolemia .
• Systemic infection .
• Aortic stenosis .
• Spina bifida and back deformity .