Impact of Real-Time Ultrasound-Guided Spinal Anesthesia Versus Landmark-Guided Spinal Anesthesia on Anesthesia Procedural Time

NCT06656793 | Completed

• 1 other identifier: Tongji Hospital102114-5
• Study Type: observational
• Target: 3,597
• Locations: 1 country
• Sites: 1

Brief Summary

Intraspinal anesthesia, traceable to the late 19th century, involves injecting local anesthetics into the spinal canal to block nerve signals, relieving pain and relaxing muscles for surgery. Compared with general anesthesia, it has advantages: smaller impact on the central nervous system, lower drug dosage (reducing systemic poisoning risk), precise block plane control (protecting respiratory/cardiac function), and benefits for mothers and fetuses. However, traditional blind puncture faces challenges in special patients (obese, post-spinal surgery, or pathological cases). It relies on "loss of sensory resistance," prone to misjudgment, leading to dura rupture or spinal cord injury. Obese pregnant women have hard-to-palpate spinous processes; the elderly have ligament calcification/narrowed intervertebral spaces, affecting positioning and ultrasound imaging. Ultrasound guidance has advanced since 1984 (first used to measure epidural space depth, reducing complications). It aids obese pregnant women in locating spinal structures, guides pediatric epidural catheter placement, and improves first-attempt success with better resolution. Adjusting the ultrasound probe to a sagittal midline inner oblique angle solves imaging issues in elderly patients. Clinically, 24G/25G fine needles for ultrasound-guided lumbar puncture may deform; the "needle-in-a-needle" technique (using a larger guide needle) reduces tissue damage and accidental dura puncture, while minimizing skin punctures. Small-sample studies confirm ultrasound's value in vertebral localization and real-time guidance, but the efficacy of ultrasound vs. surface marking remains controversial due to lack of large-sample data. This article provides evidence-based reference via retrospective analysis of 3,597 cases.

Conditions

Spinal Anesthesia

Outcome Measures

Primary Outcomes (1)

• Door to skin time (Dts)

  The time from when the patient enters the operating room until the skin incision is made.

  From 1 January 2019 to 29 May 2024

Secondary Outcomes (15)

• Operative duration

  From the incision to the completion of the surgery

• Anaesthetic duration

  From the beginning of ultrasound guided spinal anesthesia (UG-SA) to the end of anesthesia

• PACU duration

  The time from entering PACU to exiting PACU

• Blood loss

  During operation

• Other complications

  During operation

Study Arms (2)

RT-SA

Real-Time Ultrasound-Guided Spinal Anesthesia

LM-SA

Landmark-Guided Spinal Anesthesia

Eligibility Criteria

• Sex: all
• Healthy Volunteers: No
• Age Groups: Child (0-17), Adult (18-64), Older Adult (65+)
• Sampling Method: Non-Probability Sample

Study Population

All patients who received the real-time needle in needle technique UG-SA between 1 January 2019 and 29 May 2024.

You may qualify if:

• None

You may not qualify if:

• None

Sponsors & Collaborators

• Tongji Hospital: lead

Study Sites (1)

Tongji hospital, Tongji Medical College, Huazhong University of Science and Technology

Wuhan, Hubei, 430030, China

Location

Study Design

• Study Type: observational
• Observational Model: COHORT
• Time Perspective: RETROSPECTIVE
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Principal Investigator

Study Record Dates

• First Submitted: October 23, 2024
• First Posted: October 24, 2024
• Study Start: January 25, 2025
• Primary Completion: January 25, 2025
• Study Completion: January 25, 2025
• Last Updated: September 26, 2025

Record last verified: 2025-09

Locations

CN (1)