Comparison of Ultrasound-assisted versus Landmark-guided Subarachnoid Block in Patients of Ankylosing Spondylitis Undergoing Total Hip Replacement: A Prospective Randomized Trial.
Neel Kamal Mishra, Rishabh Mishra, Prem Raj Singh et al.
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In 30 seconds
This prospective randomized trial compared ultrasound-assisted with landmark-guided subarachnoid block in 60 patients with ankylosing spondylitis undergoing elective total hip arthroplasty. Patients were allocated equally between the two techniques. Ultrasound assistance produced a significantly higher first-attempt success rate for dural puncture. Procedure time was slightly longer with ultrasound, but the difference was not statistically significant; postprocedural complications were comparable. The abstract does not report the numerical success rates or other effect estimates, so the magnitude of benefit cannot be quantified from the available results.
Key findings
- Ultrasound-assisted block had a significantly higher first-attempt success rate than landmark-guided block.
- Procedural duration was slightly longer with ultrasound, but the difference was not statistically significant.
- Postprocedural complications were comparable between the two groups.
Why it matters
Spinal rigidity and altered anatomy in ankylosing spondylitis can make neuraxial procedures challenging. The trial suggests that preprocedural ultrasound may improve first-pass dural puncture success in this setting without a demonstrated increase in complications, while the unreported effect size limits assessment of the clinical magnitude.
What to keep in mind
The trial included 60 patients aged 18–60 years with ASA physical status I or II undergoing elective hip arthroplasty. The abstract provides no numerical effect estimates for success rates or complications.