Efficacy of preprocedural ultrasound-guided versus landmark-Guided spinal anesthesia in geriatric patients: A randomized comparative study
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- 1 Department of Anesthesia, Government Institute of Medical Sciences, Greater Noida, Uttar Pradesh, India
Abstract
Background: Age-related degenerative changes in the lumbar spine frequently result in technical difficulty in standard landmark-guided spinal anesthesia in geriatric populations, leading to multiple needle insertions and manipulations. Preprocedural ultrasound offers non-invasive visualization of internal spine anatomy to align needle guidance.
Objectives: To evaluate the efficacy of preprocedural ultrasound imaging compared to conventional anatomical landmark palpation for spinal anesthesia in elderly patients with challenging spinal anatomy.
Materials and Methods: In this single-center, prospective, randomized, comparative study, 140 geriatric patients (aged 60–90 years, ASA I–III) with degenerative spine changes were randomized into two groups (n = 70 per group): Group 1 (Preprocedural Ultrasound-Guided Spinal Anaesthesia) or Group 2 (Conventional Landmark-Guided Spinal Anaesthesia). The primary objective was to measure the first-pass success rate. Secondary objectives were the total needle insertion attempts, needle redirections required, landmark mapping duration, and total procedure time.
Results: The first-pass success rate was significantly higher in the ultrasound group than in the standard landmark group (0.84 ± 0.36 vs. 0.65 ± 0.47; p = 0.01). Group 1 also demonstrated a significantly reduced mean number of needle insertion attempts (1.19 ± 0.46 vs. 1.37 ± 0.54; p = 0.035) and required significantly fewer intraprocedural needle redirections (0.74 ± 1.00 vs. 1.17 ± 1.13; p = 0.02). Landmark establishment time (29.23 ± 3.00 seconds vs. 28.77 ± 2.72 seconds; p = 0.35) and overall procedural duration (86.86 ± 10.88 seconds vs. 88.97 ± 11.88 seconds; p = 0.14) were statistically comparable between both groups.
Conclusion: Preprocedural spinal ultrasound provides superior technical efficacy over standard palpatory techniques in geriatric patients. It significantly maximizes initial insertion success while reducing bone contact and corrective needle redirections without extending overall procedural time.
Dates & metrics
- Received
- 12 Jun 2026
- Accepted
- 25 Aug 2026
- Published
- 2 Nov 2026
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How to cite this article
Athota S, Nazir N. Efficacy of preprocedural ultrasound-guided versus landmark-Guided spinal anesthesia in geriatric patients: A randomized comparative study. J. Sci. Innov. Anesthesiol. 2026;1(3):79-82. doi:10.65929/JSIA.2026.1.3.004
Athota, S., & Nazir, N. (2026). Efficacy of preprocedural ultrasound-guided versus landmark-Guided spinal anesthesia in geriatric patients: A randomized comparative study. Journal of Scientific Innovations in Anesthesiology, 1(3), 79-82. https://doi.org/10.65929/JSIA.2026.1.3.004
Sushma Athota, and Nazia Nazir. "Efficacy of preprocedural ultrasound-guided versus landmark-Guided spinal anesthesia in geriatric patients: A randomized comparative study." Journal of Scientific Innovations in Anesthesiology, vol. 1, no. 3, 2026, pp. 79-82. https://doi.org/10.65929/JSIA.2026.1.3.004
Sushma Athota, and Nazia Nazir. "Efficacy of preprocedural ultrasound-guided versus landmark-Guided spinal anesthesia in geriatric patients: A randomized comparative study." Journal of Scientific Innovations in Anesthesiology 1, no. 3 (2026): 79-82. https://doi.org/10.65929/JSIA.2026.1.3.004
Athota, S., and Nazir, N. (2026) 'Efficacy of preprocedural ultrasound-guided versus landmark-Guided spinal anesthesia in geriatric patients: A randomized comparative study', Journal of Scientific Innovations in Anesthesiology, 1(3), pp. 79-82. https://doi.org/10.65929/JSIA.2026.1.3.004
© 2026 the authors. Published by REVO Publication. This article is distributed under CC BY 4.0, which permits use and redistribution provided the original work is properly cited.