CAN WE PREDICT DIFFICULTY OF SPINAL ANESTHESIA?.

Performing�spinal anesthesia is sometimes difficult.� The present study was designed to determine the predictive values of different variables specially spinal column process landmarks of patient as a major predicting factor for difficult spinal anesthesia.

Materials & Methods:�190 patients, in different age groups, ASA I-II who were subjected to surgery on lower limb and caesarean section were enrolled in an analytic cross-sectional study. Demographic data, body mass index, and spinal landmark grading score were recorded. During block, space of spinal puncture and quality of block were also recorded. The data were analyzed by correlation coefficient, Spearman's rho test to evaluate difficult spinal anesthesia.

Results: Spinal landmark grading score was strongly correlated with difficulty in performing spinal anesthesia (correlation coefficient =0.750, p<0.01). There was a weak correlation between patient weight and difficult spinal anesthesia (correlation coefficient =0.330, p< 0.01), but a direct correlation was found between body mass index and difficult spinal anesthesia (correlation coefficient =0.466, p<0.01). No correlation existed between patient height and difficult spinal anesthesia (correlation coefficient = -0.013).

Conclusion: It seems that incorporation of spinal landmark grading system in preoperative evaluation, alike mallampati classification in difficult endotracheal intubation, is valuable in predicting difficult spinal anesthesia.