{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,14]],"date-time":"2026-08-14T20:34:04Z","timestamp":1786739644098,"version":"build-2736575974"},"reference-count":17,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"Suppl 1","license":[{"start":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2026,1]]},"abstract":"\n Background and Aims:<\/jats:title>\n Dural sac cross-sectional area (DSCSA)-based intrathecal dosing aims to optimise block spread and improve haemodynamic stability during spinal anaesthesia (SA). Ultrasound-guided DSCSA measurement helps in local anaesthetic (LA) dose reduction compared with conventional fixed-dose practice. The primary objective was to determine LA dosage proportional to DSCSA reduction, while the secondary objectives included comparison of block characteristics and intra-operative haemodynamic parameters [heart rate and mean arterial pressure (HR and MAP)] between the two approaches.<\/jats:p>\n <\/jats:sec>\n \n Methods:<\/jats:title>\n \n This prospective randomised study included 60 American Society of Anesthesiologists I\u2013III patients aged >65 years undergoing orthopaedic surgery under SA. Patients were allocated to an ultrasound-guided DSCSA-based dosing group (US,\n n<\/jats:italic>\n = 30) or a control group (C,\n n<\/jats:italic>\n = 30). In Group US, DSCSA was calculated from ultrasound-measured dural sac diameter at L3\u2013L4, and hyperbaric bupivacaine dosing was individualised, while Group C received a fixed 11 mg dose. Sensory and motor block characteristics, HR, MAP, and surgical duration were recorded.\n <\/jats:p>\n <\/jats:sec>\n \n Results:<\/jats:title>\n Group US had a mean dural sac diameter of 11.99 (0.76) mm and a DSCSA of 112.98 (13.42) mm\u00b2, resulting in a mean calculated dose of 1.79 (0.14) mL. Both groups achieved a maximum motor block score of 3. Group C showed significantly greater reductions in HR, with more frequent bradycardia, and a significant decrease in MAP between 10 and 30 minutes. Surgical duration was comparable between the groups.<\/jats:p>\n <\/jats:sec>\n \n Conclusion:<\/jats:title>\n Ultrasound-guided DSCSA-based dosing improves haemodynamic stability and reduces bradycardia and hypotension while maintaining comparable block quality to conventional fixed-dose SA.<\/jats:p>\n <\/jats:sec>","DOI":"10.4103\/ija.ija_1632_25","type":"journal-article","created":{"date-parts":[[2026,1,30]],"date-time":"2026-01-30T13:00:19Z","timestamp":1769778019000},"page":"S42-S49","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":0,"title":["Ultrasound-guided measurement of cross-sectional area of dural sac to titrate the dosage of local anaesthetic in geriatric orthopaedic surgery under spinal anaesthesia: A prospective randomised study"],"prefix":"10.4103","volume":"70","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3592-0061","authenticated-orcid":false,"given":"Kiranpreet","family":"Kaur","sequence":"first","affiliation":[{"name":"Department of Anaesthesiology and Critical Care, Pt. B.D. Sharma PGIMS, Rohtak, Haryana, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-1809-3845","authenticated-orcid":false,"given":"Vaishali","family":"Bhatia","sequence":"additional","affiliation":[{"name":"Department of Anaesthesiology and Critical Care, Pt. B.D. Sharma PGIMS, Rohtak, Haryana, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1340-0228","authenticated-orcid":false,"given":"Sumedha","family":"Vashishth","sequence":"additional","affiliation":[{"name":"Department of Anaesthesiology and Critical Care, Pt. B.D. Sharma PGIMS, Rohtak, Haryana, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6460-8563","authenticated-orcid":false,"given":"Prashant","family":"Kumar","sequence":"additional","affiliation":[{"name":"Department of Anaesthesiology and Critical Care, Pt. B.D. 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