J Korean Pain Soc.  1996 Jun;9(1):126-129.

The Difference of Success Rate between the Midline Approach and the Paramedian Approach of Spinal Anesthesia in each of Flexed Patients and Straightened Patients

• Cho MH
• Lee JS

Abstract

Background
Advantages of paramedian approach over midline approach include less tissue trauma and less dependence on patients ability to assume a fetal position. When midline approach fails in patients who are difficult to take a position with lumbar spine flexed, paramedian approach to interlaminar space may succeed. Methods: Success rates of spinal anesthesia were measured for 47 flexed patients by midline approach, 48 flexed patients by paramedian approach, 23 straightened patients receiving spinal anesthesia by midline approach, and 23 straightened patients by paramedian approach. Results: Success rates in flexed patients were 100% by midline approach and 100% by paramedian approach. Success rates for straightened patients were 13.0% by midline approach and 78.3% by paramedian approach. For straightened patients there were no correlations between success rate and age, weight, Ponderal Index but there were correlations between height and midline approach of spinal anesthesia. Conclusion: Pertaining to adult Koreans, success rates of spinal anesthesia for straightened patients were less than those for flexed patients. Success rate of paramedian approach of spinal anesthesia among straightened patients were better than those of midline approach.

Keyword

Anesthetic techniques; lumbar spinal; midline approach; paramedian approach; success rate

MeSH Terms

Adult
Anesthesia, Spinal*
Humans
Spine