Clinical trial NCT06707571: Landmark Versus Ultrasongraphy Guided Spinal Anesthesia in Lower Abdominal Surgeries in Cancer Patients: a Randomized Controlled Trial
Official title: Ultrasongraphy Guided Spinal Anesthesia Versus Landmark in Lower Abdominal Surgeries in Cancer Patients: a Randomized Controlled Trial
Study type: INTERVENTIONAL
Overall status: NOT_YET_RECRUITING
Phase: NA
Conditions: Cancer Surgery
Keywords: US-guided spinal anesthesia
Lead sponsor: Assiut University
Sponsor class: OTHER
First posted: 2024-11-27
Enrollment: 52
Sex: ALL
Minimum age (years): 18
Standard ages: ADULT
OLDER_ADULT
Accepts healthy volunteers: no
Allocation: RANDOMIZED
Intervention model: PARALLEL
Primary purpose: TREATMENT

Brief summary: Spinal anesthesia is a commonly employed technique for lower abdominal surgeries, providing effective anesthesia and analgesia with minimal systemic effects. In cancer patients undergoing such procedures, careful consideration of anesthetic techniques is crucial, given their often-compromised physiological state and the need to minimize postoperative complications. Two approaches to administering spinal anesthesia are Ultrasound (US)-guided and the traditional landmark-based technique.

the aim of the study :To evaluate the efficacy, safety and feasibility of US-guided spinal anesthesia versus the landmark-based technique in cancer patients undergoing lower abdominal surgery.

Detailed description: The traditional landmark method relies on palpating anatomical structures, such as the iliac crests and spinal processes, to guide needle insertion. Although widely used, it can be challenging in patients with anatomical variations, obesity, or previous surgeries, potentially leading to multiple attempts, increased patient discomfort, or complications. On the other hand, Ultrasound (US) imaging has become an increasingly popular tool among anesthesiologists to guide neuraxial blockade. US-guided spinal anesthesia provides real-time visualization of the relevant anatomy, including the spinal canal, ligaments, and surrounding tissues, enabling more accurate needle placement. This technique has gained attention for its potential to improve success rates, reduce complications, and enhance patient comfort, particularly in complex cases such as cancer patients, where precision is vital.

By examining factors such as procedural success rates, patient comfort, complication rates, and overall outcomes, we can better understand the role of ultrasound guidance in optimizing anesthetic care for this vulnerable patient population.

Eligibility criteria: Inclusion Criteria:

* Age \>18 years old
* Both sex
* patients with a body mass index (BMI) of 18-40 kg/m2
* American Society of Anesthesiologists (ASA) physical status classification of I to III.

Exclusion Criteria:

* • Patients have a contraindication for regional anesthesia, e.g. coagulopathy.

  * Failed or unsatisfactory intrathecal block.
  * Patients with known hypersensitivity to amide local anesthetics.
  * Local injection site infection or spinal deformity.
  * Severe hypotension.
  * Space occupying lesions of the brain.
  * Hypovolemia.
  * Pregnancy.

Primary outcomes:
measure: the first-pass success rate of Combined spinal-epidural anesthesia
timeFrame: baseline
Secondary outcomes:
Other outcomes:
Locations:
Study officials:
References:
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