Using “Baudhayana Theorem” for a Novel Paramedian Approach of Spinal Anesthesia in Morbidly Obese Patients with Difficult Sonoanatomy: A Case Report and Narrative Review
Spinal anesthesia is traditionally performed using landmark technique to identify the level and point of needle insertion. However use of ultrasonography (USG) has emerged among anaesthesiologists to guide neuraxial blockade. The views that are of utmost importance are “transverse spinous view”, “t...
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| Format: | Article |
| Language: | English |
| Published: |
Tehran University of Medical Sciences
2023-04-01
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| Series: | Archives of Anesthesia and Critical Care |
| Subjects: | |
| Online Access: | https://aacc.tums.ac.ir/index.php/aacc/article/view/552 |
| _version_ | 1797826781079666688 |
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| author | Poonam Arora Niyati Arora |
| author_facet | Poonam Arora Niyati Arora |
| author_sort | Poonam Arora |
| collection | DOAJ |
| description |
Spinal anesthesia is traditionally performed using landmark technique to identify the level and point of needle insertion. However use of ultrasonography (USG) has emerged among anaesthesiologists to guide neuraxial blockade. The views that are of utmost importance are “transverse spinous view”, “transverse interspinous view” and “longitudinal parasagittal oblique view”. For in-plane technique and real time imaging longitudinal parasagittal oblique view is used while transverse views are used for visualizing spinous level, epidural and subarachnoid space, posterior complex (PC), anterior complex (AC) and depth of canal. In patients with deformed spine like kyphoscoliosis or morbid obesity obtaining optimum views is not possible. We discuss a morbidly obese patient with very poor ultrasonographic views of spine. We describe a novel technique to estimate depth of spinal canal using only bony shadows in a single transverse view.
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| first_indexed | 2024-04-09T12:38:48Z |
| format | Article |
| id | doaj.art-87baddbd4a154092ab66c27d063ec7fc |
| institution | Directory Open Access Journal |
| issn | 2423-5849 |
| language | English |
| last_indexed | 2024-04-09T12:38:48Z |
| publishDate | 2023-04-01 |
| publisher | Tehran University of Medical Sciences |
| record_format | Article |
| series | Archives of Anesthesia and Critical Care |
| spelling | doaj.art-87baddbd4a154092ab66c27d063ec7fc2023-05-15T06:07:29ZengTehran University of Medical SciencesArchives of Anesthesia and Critical Care2423-58492023-04-019210.18502/aacc.v9i2.12519Using “Baudhayana Theorem” for a Novel Paramedian Approach of Spinal Anesthesia in Morbidly Obese Patients with Difficult Sonoanatomy: A Case Report and Narrative ReviewPoonam Arora0Niyati Arora1Department of Anesthesiology,All India Institute of Medical Sciences, Rishikesh, India.Department of Anesthesiology,All India Institute of Medical Sciences, Rishikesh, India. Spinal anesthesia is traditionally performed using landmark technique to identify the level and point of needle insertion. However use of ultrasonography (USG) has emerged among anaesthesiologists to guide neuraxial blockade. The views that are of utmost importance are “transverse spinous view”, “transverse interspinous view” and “longitudinal parasagittal oblique view”. For in-plane technique and real time imaging longitudinal parasagittal oblique view is used while transverse views are used for visualizing spinous level, epidural and subarachnoid space, posterior complex (PC), anterior complex (AC) and depth of canal. In patients with deformed spine like kyphoscoliosis or morbid obesity obtaining optimum views is not possible. We discuss a morbidly obese patient with very poor ultrasonographic views of spine. We describe a novel technique to estimate depth of spinal canal using only bony shadows in a single transverse view. https://aacc.tums.ac.ir/index.php/aacc/article/view/552SpinalAnesthesiaObesityUltrasonographyTheoremSpine |
| spellingShingle | Poonam Arora Niyati Arora Using “Baudhayana Theorem” for a Novel Paramedian Approach of Spinal Anesthesia in Morbidly Obese Patients with Difficult Sonoanatomy: A Case Report and Narrative Review Archives of Anesthesia and Critical Care Spinal Anesthesia Obesity Ultrasonography Theorem Spine |
| title | Using “Baudhayana Theorem” for a Novel Paramedian Approach of Spinal Anesthesia in Morbidly Obese Patients with Difficult Sonoanatomy: A Case Report and Narrative Review |
| title_full | Using “Baudhayana Theorem” for a Novel Paramedian Approach of Spinal Anesthesia in Morbidly Obese Patients with Difficult Sonoanatomy: A Case Report and Narrative Review |
| title_fullStr | Using “Baudhayana Theorem” for a Novel Paramedian Approach of Spinal Anesthesia in Morbidly Obese Patients with Difficult Sonoanatomy: A Case Report and Narrative Review |
| title_full_unstemmed | Using “Baudhayana Theorem” for a Novel Paramedian Approach of Spinal Anesthesia in Morbidly Obese Patients with Difficult Sonoanatomy: A Case Report and Narrative Review |
| title_short | Using “Baudhayana Theorem” for a Novel Paramedian Approach of Spinal Anesthesia in Morbidly Obese Patients with Difficult Sonoanatomy: A Case Report and Narrative Review |
| title_sort | using baudhayana theorem for a novel paramedian approach of spinal anesthesia in morbidly obese patients with difficult sonoanatomy a case report and narrative review |
| topic | Spinal Anesthesia Obesity Ultrasonography Theorem Spine |
| url | https://aacc.tums.ac.ir/index.php/aacc/article/view/552 |
| work_keys_str_mv | AT poonamarora usingbaudhayanatheoremforanovelparamedianapproachofspinalanesthesiainmorbidlyobesepatientswithdifficultsonoanatomyacasereportandnarrativereview AT niyatiarora usingbaudhayanatheoremforanovelparamedianapproachofspinalanesthesiainmorbidlyobesepatientswithdifficultsonoanatomyacasereportandnarrativereview |