EVALUATION OF PREDICTORS FOR DIFFICULT LUMBAR NEUROAXIAL BLOCK BY USING ULTRASONOGRAPHY

Introduction: The neuraxial block, whether spinal or epidural, is commonly used as an anesthetic technique for the performance of surgeries or the treatment of chronic pain. In studies carried out, described by authors such as Kallidaikurichi et al and Grau et al, it has been shown that even experienced anesthesiologists are able to find the adequate intervertebral space in only 29% of patients who undergo this type of anesthetic procedure. Objectives: To determine the association of ultrasonographic parameters with the technical difficulty of lumbar neuraxial block, in patients undergoing elective surgery. Take ultrasound measurements that include the distance between the skin and the spinous process of L1, L2, L3, L4 and L5. To determine whether the presence of the yellow ligament and / or the posterior longitudinal ligament could be visualized by ultrasound. Assess whether there was concordance between the level determined by the palpation technique of anatomical landmarks and the ultrasound examination. Classify the level of difficulty of the neuraxial block based on the number of punctures, as well as the number of redirections of the needle during blocking. Method: This study included 45 electronic records of patients who underwent elective surgery at the Naval Medical Center in a period from May 2019 to May 2020 and whose anesthesia technique included Lumbar Neuroaxial Block and who also underwent a ultrasonographic tracking for the collection of anatomical data. Results: The results obtained in the analysis of these were not significant for the general objective of our study, however they helped us to conclude that the space referred by anesthesiologists and the one actually approached agrees only in 68.9%. Conclusions: Performing ultrasonography prior to performing BNA can improve its performance.