Context: Spinal anaesthesia is a blind landmark based procedure, it can be challenging in some patients. The subarachnoid space should preferably be identified at the first attempt, as multiple punctures are associated with pain and patient discomfort, increase risk of postdural puncture headache, spinal hematoma formation, trauma to neural structures and permanent neurological sequalae. Predictors to assess the difficulty of spinal anaesthesia increases the chances of success with this blind technique prevent multiple attempts and add to patient comfort, thus increasing the quality of healthcare. Aims: We formulated this study to assess the ease/difficulty of spinal anaesthesia based on width of interspinous gap (ISG) and patient’s characteristics.
Settings and Design: A prospective observational study conducted in 77 ASA I and II patients of either sex and age between 18-65 years, posted for elective or emergency surgery under spinal anaesthesia. Methods
and Material: The ISG was measured using vernier caliper at L4-L5 level in optimal flexed sitting position before spinal anaesthesia. The number of attempts, redirections and requirement of another spinal level were recorded. Statistical analysis used: Mean and Standard Deviation, Chi-square test, Independent t-test and p value. Results: The demographic data like age, gender, body mass index and type/gauge of spinal needle did not have any correlation with the ease of spinal anaesthesia while ISG was found to be significantly lower (p = 0.000) in patients who required more number of redirections, attempts and levels. Conclusions: ISG is a good predictor for the ease of spinal anaesthesia.