{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,19]],"date-time":"2026-08-19T20:06:58Z","timestamp":1787170018055,"version":"build-2736575974"},"reference-count":13,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"5","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2021,5]]},"abstract":"\n Background and Aims:<\/jats:title>\n Spinal anaesthesia is conventionally performed using a landmark-guided midline approach. These surface landmarks may be absent, indistinct or distorted in the presence of obesity, previous spinal surgeries, deformities, or degenerative changes associated with ageing. In the present study, we compared the efficacy of real-time ultrasound (RUS)-guided paramedian approach, and pre-procedure ultrasound (PUS) landmark-guided paramedian approach in obese patients.<\/jats:p>\n <\/jats:sec>\n \n Methods:<\/jats:title>\n Eighty patients with body mass index (BMI) >30 kg\/m2 were included in the study. The participants were randomly assigned to two intervention groups, i.e., RUS and PUS approach. The primary end point was to attain a successful lumbar puncture. Variables like the number of attempts, the number of passes, the time taken for identifying landmark(s), and time for a successful lumbar puncture(s) were secondary end points and were recorded in both the groups.<\/jats:p>\n <\/jats:sec>\n \n Results:<\/jats:title>\n \n The median number of attempts were 4 (IQR 2-4) and 2 (IQR 1-2), respectively, in the PUS and RUS group (\n P<\/jats:italic>\n -value < 0.001). The median number of passes, the median time for identifying space, and the time for successful lumbar puncture was statistically significantly less in the RUS group, than the PUS group.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusion:<\/jats:title>\n The time taken for the identification of the space, the number of attempts, number of passes, and the time taken for successful lumbar puncture was more in the PUS group as compared to the RUS group.<\/jats:p>\n <\/jats:sec>","DOI":"10.4103\/ija.ija_446_20","type":"journal-article","created":{"date-parts":[[2021,12,1]],"date-time":"2021-12-01T02:03:07Z","timestamp":1638324187000},"page":"356-361","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":28,"title":["Real-time ultrasound-guided spinal anaesthesia vs pre\u2013 procedural ultrasound-guided spinal anaesthesia in obese patients"],"prefix":"10.4103","volume":"65","author":[{"given":"Parli Raghavan","family":"Ravi","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sudarshan","family":"Naik","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mukund C","family":"Joshi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Seema","family":"Singh","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"R1-2-20240902","doi-asserted-by":"crossref","first-page":"34","DOI":"10.1097\/AAP.0b013e3182734927","article-title":"The utility of ultrasound imaging in predicting ease of performance of spinal anaesthesia in an orthopedic patient population","volume":"38","author":"Chin","year":"2013","journal-title":"Reg Anesth Pain Med"},{"key":"R2-2-20240902","first-page":"525818","article-title":"Real-time ultrasound-guided spinal anaesthesia: A prospective observational study of a new approach?","volume":"2013","author":"Conroy PH","year":"2013","journal-title":"Anesthesiol Res Pract"},{"key":"R3-2-20240902","doi-asserted-by":"crossref","first-page":"799","DOI":"10.1093\/bja\/aex108","article-title":"Real-time ultrasound paramedian spinal anaesthesia: Evaluation of the efficacy and the success rate of single needle pass","volume":"118","author":"Chong","year":"2017","journal-title":"Br J Anaesth"},{"key":"R4-2-20240902","doi-asserted-by":"crossref","first-page":"1089","DOI":"10.1213\/ANE.0000000000000911","article-title":"Conventional landmark-guided midline versus preprocedure ultrasound-guided paramedian techniques in spinal anesthesia","volume":"121","author":"Kallidaikurichi Srinivasan","year":"2015","journal-title":"Anesth Analg"},{"key":"R5-2-20240902","doi-asserted-by":"crossref","first-page":"213","DOI":"10.1016\/j.ijoa.2014.03.001","article-title":"Ultrasound-guided spinal anaesthesia in obstetrics: Is there advantage over landmark technique in patients with easily palpable spines?","volume":"23","author":"Ansari","year":"2014","journal-title":"Int J Obstet Anesth"},{"key":"R6-2-20240902","doi-asserted-by":"crossref","first-page":"896","DOI":"10.1007\/s12630-013-9984-9","article-title":"Single-operator real-time ultrasound-guided spinal injection using SonixGPS: A case series","volume":"60","author":"Brinkmann","year":"2013","journal-title":"Can J Anaesth"},{"key":"R7-2-20240902","doi-asserted-by":"crossref","first-page":"280","DOI":"10.4103\/ija.IJA_488_17","article-title":"Comparison of landmark versus pre-procedural ultrasonography- assisted midline approach for identification of subarachnoid space in elective caeserean section: A randomised controlled trial","volume":"62","author":"Dhanger","year":"2018","journal-title":"Indian J Anaesth"},{"key":"R8-2-20240902","first-page":"573","article-title":"Real-time ultrasound-guided spinal anaesthesia using Sonix GPS ultrasound guidance system; A feasibility study","volume":"71","author":"Niazi","year":"2016","journal-title":"Acta Anaesthesiol Scand"},{"key":"R9-2-20240902","doi-asserted-by":"crossref","first-page":"53","DOI":"10.4103\/ija.IJA_448_17","article-title":"Pre-procedure ultrasound-guided paramedian spinal anaesthesia at L5-S1: Is this better than landmark-guided midline approach.A randomised controlled trial?","volume":"62","author":"Srinivasan","year":"2018","journal-title":"Indian J Anaesth"},{"key":"R10-2-20240902","doi-asserted-by":"crossref","first-page":"377","DOI":"10.4103\/0019-5049.183398","article-title":"Comparison od ultrasound imaging in transverse median and parasagital oblique planes for thoracic epidurals: A pilot study","volume":"60","author":"Khemka","year":"2016","journal-title":"Indian J Anaesth"},{"key":"R11-2-20240902","doi-asserted-by":"crossref","first-page":"1007","DOI":"10.1007\/s00586-011-2029-6","article-title":"Spinous process morphology: The effect of ageing through adulthood on spinous process size and relationship to sagittal alignment","volume":"21","author":"Aylott","year":"2012","journal-title":"Eur Spine J"},{"key":"R12-2-20240902","doi-asserted-by":"crossref","first-page":"12","DOI":"10.1016\/j.ijoa.2016.07.007","article-title":"Ultrasound to identify the lumbar space in women with impalpable bony landmarks presenting for elective caesarean delivery under spinal anaesthesia: A randomised trial","volume":"28","author":"Creaney","year":"2016","journal-title":"Int J Obstet Anesth"},{"key":"R13-2-20240902","doi-asserted-by":"crossref","first-page":"817","DOI":"10.1007\/s12630-010-9337-x","article-title":"The use of ultrasound for lumbar spinous process identification: A pilot study","volume":"57","author":"Halpern","year":"2010","journal-title":"Can J Anesth"}],"container-title":["Indian Journal of Anaesthesia"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ovid.com\/10.4103\/ija.IJA_446_20","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,19]],"date-time":"2026-08-19T19:16:43Z","timestamp":1787167003000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ovid.com\/10.4103\/ija.IJA_446_20"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,5]]},"references-count":13,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2021]]}},"URL":"https:\/\/doi.org\/10.4103\/ija.ija_446_20","relation":{},"ISSN":["0019-5049"],"issn-type":[{"value":"0019-5049","type":"print"}],"subject":[],"published":{"date-parts":[[2021,5]]}}}