Abstract

Subarachnoid block has become very popular for lower abdominal and lower limb (surgical and orthopedic) surgeries. A relatively simple, easy and economical scoring system is devised pre operatively to assess the technical difficulty of performing subarachnoid block. Present study was aimed to study a predicting score for a difficult subarachnoid block at a tertiary hospital. Material and Methods: Present study was single-center, prospective, observational study, conducted in patients aged 21 -80 years, belonging to ASA physical status class I and II, undergoing surgeries below umbilicus and lower limb, under subarachnoid block. Parameters assessed were predictive score, number of attempts made & number of new skin pricks. Results: The sampling method included 275 cases. Spinal landmark was palpable in 87% of patients and it was not palpable in 13% of patients. There is a statistically significant association with P<0.0001 between the score and number of attempts. As the score is 4 or > 4 (which indicates a difficult subarachnoid block performance), the number of attempts to perform a successful block is increased. There is a statistically significant association with age and score. There is a statistical significance between BMI and the number of attempts with P<0.0001. There is a statistical significance between BMI and number of new skin pricks with a P<0.0001.As the BMI increases the number of skin pricks made for successful subarachnoid block increases. There is a statistical significance between the number of new skin prick and the number of attempts made for a successful subarachnoid block with a P<0.0001. Conclusion: Total score increases with increase in age, BMI, non-palpability of spinal landmark and presence of abnormal spine. This scoring system is very simple, easy and economical method done preoperatively to assess the patient body characteristics and devising a score.

Description