Comparison of Hemodynamic Stability Between Ultrasound-Guided and Landmark-Guided Spinal Anaesthesia in Patients Undergoing Elective Lower Limb Surgery

Abstract

Background: Spinal anaesthesia is widely used for elective lower limb surgery, but intraoperative hypotension remains a common concern. Ultrasound guidance may improve the technical accuracy of neuraxial procedures; however, its influence on hemodynamic stability compared with the conventional landmark-guided technique requires further evaluation.

Methods: This prospective, randomized comparative study was conducted at Rajarajeshwari Medical College and Hospital, Bengaluru, over one year. A total of 100 patients undergoing elective lower limb surgery under spinal anaesthesia were allocated equally into an ultrasound-guided group (Group U, n = 50) and a landmark-guided group (Group L, n = 50).

Results: First-attempt success was significantly higher in Group U than in Group L (86.0% vs 62.0%; P = 0.006). The ultrasound-guided group required fewer needle insertion attempts and redirections and had a shorter procedure duration. Mean systolic blood pressure and mean arterial pressure were significantly better maintained during the early intraoperative period in Group U.

Conclusion: Ultrasound-guided spinal anaesthesia was associated with improved procedural efficiency and greater hemodynamic stability compared with landmark-guided spinal anaesthesia in patients undergoing elective lower limb surgery.