Anaesthetic Assessment Research Articles

Chinese expert consensus on pediatric anesthesia assessment and perioperative risk prediction (2024 edition)

The incidence of perioperative adverse events in children aged 0 to 15 years was 5.2%. Preoperative scientific and accurate anesthesia assessment is a crucial step in ensuring the safety of pediatric surgery. Perioperative risk prediction is a digital quantitative evaluation of the level of perioperative risk, which classifies the degree of danger. In order to further standardize the methods of anesthesia assessment and identify risk factors, Chinese Society of Anesthesiology organized experts in anesthesiology from children's specialty hospitals and general hospitals, along with statisticians from public health colleges, to jointly draft the "Chinese expert consensus on pediatric anesthesia assessment and perioperative risk prediction (2024 edition)".The anesthesia assessment includes history collection, physical examination, laboratory examination, American Society of Anesthesiologists physical status, difficult airway assessment, and identification and assessment of critically sick children. Perioperative risk prediction includes preoperative anxiety, perioperative respiratory adverse events, regurgitation and aspiration, emergence delirium, postoperative nausea and vomiting, postoperative ICU admission, postoperative acute kidney injury, perioperative mortality, and risk prediction for in-hospital mortality in children with congenital heart disease undergoing non-cardiac surgery.This consensus has formulated a total of 16 recommendations, aiming to promote anesthesiologists' familiarity with the content of pediatric anesthesia assessment, identify risk factors for adverse events during the perioperative period, and take targeted measures to reduce the occurrence of adverse events and improve the safety of children during the perioperative period.

The teaching and assessment of local anaesthesia in UK dental schools.

Local anaesthesia (LA) is fundamental to successful dental treatment. Graduating hygienists, therapist and dentists should be confident and proficient in delivering LA. There is one previously published article reviewing LA teaching in United Kingdom (UK) dental schools in 2016, and at this time 10 out of 14 schools allowed peer-to-peer administration. The method of teaching LA administration has become an area of debate in terms of legality and morality given the potential complications and issues with valid consent. The aim of the study was to explore current teaching practices and assessment of LA in UK dental schools. Two national surveys (2020 and 2023) were sent out via the ABAOMS Education Committee to all 16 dental schools in the United Kingdom with dental and/or hygiene and therapy programmes. There was a 100% response rate from all schools. There has been a significant shift from peer-to-peer administration of local anaesthesia, with only 4 schools now allowing peer-to-peer administration. The majority of schools use simulation methods to deliver the teaching, including LA models, cadavers and 'cap-on' simulation with a peer. When comparing the timing of teaching between 2020 and 2023, BDS students now administer their first LA injection to a patient later in the programme, and there has been a reduction in intra-professional teaching. Due to the large shift away from practicing LA on peers, there is a need for further development of simulation methods given the drawbacks with current models and the limited development of haptic technology in relation to LA.

Assessment of surgical, anesthesia, and obstetric workforce in Somalia.

One of the core indicators recommended by the Lancet Commission is surgical workforce density, aiming to improve the number of surgery, anesthetists, and obstetric (SAO) providers to 20 per 100,000 population by 2030. We assessed SAO workforce capacity in Somalia and made recommendations for improvement. A cross-sectional study was conducted using a structured questionnaire from the WHO Program for Global Surgery and Social Change (PGSSC) Surgical Assessment Tool. All hospitals that offer surgical care services were included. A descriptive analysis was conducted using the statistical software SPSS. Of the 55 surveyed facilities providing surgical care services, 28 (50.9%) were public, mainly in urban areas. We found that there were 474 SAO specialists and non-specialists (SAO providers) and 446 other important personnel (e.g., midwives, radiologists, and pathologists). Out of 474 SAOs, Banadir had 288. Overall, surgery specialties were the most prevalent profession among SAO providers' workforce, accounting for 160 (33.7%) surgery specialists, with 1.2 per 100,000 population. The six states of Somalia have 54 OB/GYN specialists (0.4 per 100,000 population). There were a total of 22 anesthesia specialists, with a ratio of 0.2 anesthesia specialists per 100,000 population. We found a serious shortage of the SAO workforce in Somalia, and it is unlikely to meet the 2030 Lancet Commission on Global Surgery targets. There is a need for additional training of SAO providers who can offer effective leadership in surgical care services to combat the extremely avoidable surgical-related morbidities and mortalities.

Determination of Gastric Volume by Different Administration Methods before Painless Gastroscopic Anesthesia and Risk assessment of aspiration

Determination of Gastric Volume by Different Administration Methods before Painless Gastroscopic Anesthesia and Risk assessment of aspiration

Optimizing peripheral regional anaesthesia: strategies for single shot and continuous blocks.

Regional anaesthesia is increasingly prominent within anaesthesia, offering alternative analgesic options amidst concerns over opioid-based analgesia. Since Halsted's initial description, the field has burgeoned, with ultrasound visualization revolutionizing local anaesthetic spread assessment, leading to the development of numerous novel techniques. The benefits of regional anaesthesia have gained increasing evidence to support their application, leading to changes within training curricula. Consequently, regional anaesthesia is at a defining moment, embracing the development of core skills for the general anaesthesiologist, whilst also continuing the advancement of the specialty. Recent priority setting projects have focussed attention on key aspects of regional anaesthesia delivery, including pain management, conduct and efficacy, education, and technological innovation. Developments in our current understanding of anatomy and pharmacology, combined with strategies for optimizing the conduct and maximizing efficacy of techniques, minimizing complications, and enhancing outcomes are explored. In addition, advancements in education and training methodologies and the integration of progress in novel technologies will be reviewed. This review highlights recent scientific advances in optimizing both single-shot and continuous peripheral regional anaesthesia techniques. By synthesizing these developments, this review offers valuable insights into the evolving landscape of regional anaesthesia, aiming to improve clinical practice and patient care.

Mapping patient education encounters in elective surgery: a cohort study and cross-sectional survey

ObjectiveDevelop a process map of when patients learn about their proposed surgery and what resources patients use to educate themselves.DesignA mixed methods design, combining semistructured stakeholder interviews, quantitative validation using...

Risk assessment in equine anesthesia: a first evaluation of the usability, utility and predictivity of the two-part CHARIOT

IntroductionAn accurate risk score that can predict peri-anesthetic morbidity and mortality in equine patients could improve peri-operative management, outcome and client communication.Materials and methodsThree hunded horses underwent pre-anesthetic risk assessment using the American Society of Anesthesiologists-Physical Status augmented with equine-specific diseases (ASA-PS-Equine), a multifactorial 10-part rubric risk scale (10-RS), and a combination of both, the Combined horse anesthetic risk identification and optimization tool (CHARIOT). Intra-and post-anesthetic complications, the recovery phase and mortality were recorded over a period of 7 days following general anesthesia. To compare the utility and predictive power of the 3 scores, data were analyzed using binominal logistic regression (p ≤ 0.05) and receiver operating characteristic curve analysis. In addition, inter-observer reliability, speed, safety, ease of use and face validity of the ASA-PS-Equine and the 10-RS were analyzed based on five hypothetical patients.ResultsAll scores showed statistically significant associations with various intra-anesthetic complications and parameters of the recovery phase. The discriminant ability of the scores related to the occurrence of intra-anesthetic (AUC = 0.6093–0.6701) and post-anesthetic (AUC = 0.5373–0.6194) complications was only low. The highest diagnostic accuracy for all scores was observed for overall mortality (AUC = 0.7526–0.7970), with the ASA-PS-Equine differentiating most precisely (AUC = 0.7970; 95% CI 0.7199–0.8741). Inter-observer reliability was fair for the 10-RS (κ = 0.39) and moderate for the ASA-PS-Equine (κ = 0.52). Patient assignment to the CHARIOT was predominantly rated as rather easy and quick or very quick.Limitations and conclusionThe main limitations of the study are the monocentric study design and failure to obtain the full range of points. In conclusion, all 3 scores provide useful information for predicting the mortality risk of equine patients undergoing general anesthesia, whereas intra-and postoperative complications cannot be predicted with these scores.

Physiological changes and the Mallampati classification: Tracheal intubation complications

Introduction: Difficulty in tracheal intubation is a significant factor in morbidity and mortality. Mallampati has therefore made it possible to predict it in advance. Its classification is based on the visualization of pharyngeal structures and is a simple anesthetic assessment. In practice, some circumstances can modify Mallampati's classification, making intubation more complex, and knowledge of these is of medical importance. Objectives: To review the literature on circumstances that alter Mallampati's classification. Methods: A literature review was carried out on possible physiological alterations responsible for changes in the Mallampati classification. We searched the Medline, Scielo and CRD databases for the terms: “Mallampati modification” and “Mallampati score” associated with “anaphylaxis” and “labor” and the articles were submitted to critical analysis. Results: Among the interferences in the Mallampati score is anaphylaxis, which results in upper airway edema, affecting the classification. In addition, pregnancy and labor can influence the score. Some factors such as breast growth, weight gain and pharyngeal edema increase the index in pregnant women. In addition, there is airway edema, explained by exertion and increased venous pressure in the upper body. In addition, fluid overload and the antidiuretic effect of oxytocin cause changes in the airways. Another situation is that of pediatric patients, where 13% of respiratory problems during anesthesia are related to intubation difficulties. In children between 4 and 8 years old without malformations, the index has proved applicable. However, it is impossible to use it in children under 4 years of age. Conclusions: The Mallampati score complements the judgment of a general examination that includes anamnesis and physical inspection of the craniofacial structure to identify risk factors, taking into account other situations that may interfere with the classification. Therefore, an understanding of its limitations is necessary for its correct application.

How Is the Nociceptive Withdrawal Reflex Influenced by Increasing Doses of Propofol in Pigs?

The nociceptive withdrawal reflex (NWR) is a physiological, polysynaptic spinal reflex occurring in response to noxious stimulations. Continuous NWR threshold (NWRt) tracking has been shown to be possibly useful in the depth of anesthesia assessment. The primary aim of this study was to describe how propofol modulates the NWRt over time in pigs. Five juvenile pigs (anesthetized three times) were included. An intravenous (IV) infusion of propofol (20 mg/kg/h) was started, and boli were administered to effect until intubation. Afterwards, the infusion was increased every ten minutes by 6 mg/kg/h, together with an IV bolus of 0.5 mg/kg, until reaching an electroencephalographic suppression ratio (SR) of between 10% and 30%. The NWRt was continuously monitored. For data analysis, the time span between 15 min following intubation and the end of propofol infusion was considered. Individual durations of propofol administration were divided into five equal time intervals for each pig (TI1-TI5). A linear regression between NWRt and TI was performed for each pig. Moreover, the baseline NWRt and slopes of the linear regression (b1) were compared among days using a Friedman Repeated Measures Analysis of Variance on Ranks. The NWRt always increased with the propofol dose (b1 = 4.71 ± 3.23; mean ± standard deviation). No significant differences were found between the baseline NWRt and the b1 values. Our results suggest that the NWRt may complement the depth of anesthesia assessment in pigs receiving propofol.

Pre-operative immune cell numbers and ratios are associated with peri-operative adverse outcomes in transfused patients

Background and objectivesTransfusion-related immune modulation (TRIM) and associated adverse outcomes during major surgery are increasingly important to patients and health services internationally. A panel of pre-operative blood tests is an essential part of the pre-operative anaesthetic assessment. This panel of blood tests commonly considers numbers of immune cells (i.e., lymphocytes, monocytes, and neutrophils and cell ratios) that may be used as biomarkers to evaluate and potentially predict post-operative adverse outcomes.DesignThis retrospective data collection from eight hospital databases, within the Royal Brisbane and Women's Hospital, considered only patients who received blood transfusion during surgery (2016–2018) (n = 2,121). The association between pre-operative immune cell numbers and ratios and adverse outcomes were assessed. Adverse outcomes were coded using the International Classification of Diseases-10 (ICD-10) coding which specifically considered transfusion-related immune modulation. Results were adjusted for confounding factors.ResultsAfter adjustment, decreased pre-operative lymphocyte numbers and increased neutrophil/lymphocyte ratio (NLR) were associated with increased odds of developing infection; decreased NLR with decreased odds of developing adverse renal outcomes; and decreased lymphocyte numbers with decreased odds of developing adverse cardiovascular outcomes. Monocyte numbers, neutrophil numbers, and the lymphocyte/monocyte ratio (LMR) were not associated with increased adverse outcomes after adjustment.ConclusionPre-operative lymphocyte numbers and NLR are associated with adverse outcomes during peri-operative transfusion. Future assessment of peri-operative immune modulation should include the assessment of immune cell function and numbers.

The importance of simulation-based multi professional training in obstetric anesthesia: an update.

Simulation-based training remains an integral component of medical education by providing a well tolerated, controlled, and replicable environment for healthcare professionals to enhance their skills and improve patient outcomes. Simulation technology applied to obstetric anesthesiology continues to evolve as a valuable tool for the training and assessment of the multidisciplinary obstetric care team. Simulation-based technology has continued to play a role in training and assessment, including recent work on interdisciplinary communication, recognition, and management of obstetric hemorrhage, and support in the low or strained resource setting. The COVID-19 pandemic has accelerated the evolution of simulation-based training away from a reliance on in-situ or high-fidelity manikin-based approaches toward an increasing utilization of modalities that allow for remote or asynchronous training. The evolution of simulation for interdisciplinary training and assessment in obstetric anesthesia has accelerated, playing a greater role in aspects of communication, management of hemorrhage and supporting low or strained resource settings. Augmented reality, virtual reality and mixed reality have advanced dramatically, spurred on by the need for remote and asynchronous simulation-based training during the pandemic.

The Effect of Pre-Anesthesia Assessment on Patient Safety in the Operating Room

Background: The development of the science of anesthesia provides consideration in administering the type of anesthesia used. The pre-anesthesia assessment is the basis for planning the findings on the monitor during and after anesthesia. The completeness of the pre-anesthesia assessment has an important role in patient safety, if the anesthetic assessment is not properly completed it allows errors in the operation process. Patient safety goals are the main requirement to be implemented in all hospitals accredited by KARS. Patient safety goals intend to drive specific improvements in patient safety. This goal highlights problematic areas of health care. The wrong-site, wrong procedure and wrong-patient surgery are something that is worrying and not uncommon in the hospital. This error resulted from ineffective communication between members of the surgical team, not involving the patient in site marking, and no procedure for verifying the surgical site. Objective: The study aims to see the effect of the completeness of the pre-anesthesia assessment on patient safety. Methods: The research design is a cross-sectional study. The population in this study were patients who underwent surgery with a total sample of 70 people. Data processing through the stages of editing, coding, entry, and cleaning. Univariate analysis and bivariate analysis used the chi-square test with a 95% degree of confidence α = 0.05. Results: The results showed that the completeness of the pre-anesthesia assessment was complete with a percentage of 88.6%. Good patient safety with a percentage of 65.7%. There was no significant relationship between the completeness of the pre-anesthesia assessment and patient safety (p=0.076). Conclusions: To improve the implementation of pre-anesthesia assessments, hospitals need to review the completeness of filling out pre-anesthesia assessments by anesthesiologists before patients are operated on, to prevent errors in improving patient safety. Prepare facilities and infrastructure for the needs of patient safety programs by accreditation standards.

Preoperative anaesthesia assessment and patient preparation for surgery: update and a review

Although anaesthetic and surgical procedures should be individualised for every patient, in practice many preoperative protocols and routines are used generally. The “Helsinki Declaration on Patient Safety in Anaesthesiology” establishes that the safety and quality of the perioperative care received by patients is the responsibility of anaesthesiologists. This declaration has been accepted by all the European Societies of Anaesthesiology and stipulates that all institutions providing perioperative anaesthesia care to patients should design protocols to guide perioperative patient management. The present article aims to provide an evidenced-based review of preoperative assessment and preparation and to propose a protocol that can be adapted to the needs of each hospital and be incorporated into their routine practice. Emphasis is placed on the importance of correct preoperative evaluation in reducing morbidity and mortality in the surgical patient. This task can be aided by the use of preoperative questionnaires and the rational use of preoperative tests, which will also reduce unnecessary costs. Finally, the most widely accepted recommendations on preoperative fasting is discussed. The anaesthesiologist’s legal responsibility, and patients’ views in the preoperative process are also considered. A thorough clinical preoperative evaluation of the patient is more important than routine preoperative tests, which should be requested only when justified by clinical indications. Moreover, this practice eliminates unnecessary cost without compromising the safety and quality of care.

Perioperative geriatrics: A bibliometric analysis of the top 100 cited articles in an emerging specialty.

The success of modern medicine has led to surgery being performed on an increasingly older, frailer and more comorbid population. As a result, perioperative geriatrics has emerged as an important specialty, relevant to both medical and surgical disciplines. Only a small number of papers have been published on the topic. A bibliometric analysis is used to identify themes and trends in current research and practice. To identify and describe research topics relating to perioperative geriatrics; to find themes and gaps in the current literature. Thompson Reuters Web of Science indexing database was searched for all manuscripts relating to perioperative geriatrics. Of these, the top 100 were subcategorised into manuscript type, age, theme, specialty, journal and citation rate. The highest cited article was by Bhandari et al with 294 citations. The highest citation rate was achieved by Partridge et al, with 23.75 citations/year. Across the series, the mean number of citations was 50.41 (range 294-12). The highest number of manuscripts were published between 2010 and 2019 (n = 55), with 70% of manuscripts published in journals with impact factor <5. The specialty with the highest number of publications was orthopaedics (n = 36). Most articles focussed on surgical management of geriatrics patients, followed by anaesthetic management. This is the first bibliometric analysis of the top 100 most cited papers in perioperative geriatrics. Only 395 papers were returned, indicating that this needs to be further researched as a topic. Key themes identified were surgical management of hip fractures and anaesthetic preoperative assessment. Emerging themes from this study highlight the need for perioperative publications in the fields of geriatric vascular, general, plastic and gynaecology.

Chronic postoperative pain after non-intubated uniportal VATS lobectomy.

Patients undergoing thoracic surgery are at increased risk of developing, long-lasting pain. Beyond the non-surgical factors, the type of operation, including the number of incisions, and the anesthetic assessment seemed to be important factors, although some studies are controversial. The aim of our study was to examine the presence of chronic postoperative pain after non-intubated uniportal VATS lobectomy. We examined the difference between the intubated, relaxed and non-intubated spontaneous ventilation surgical approaches in patients who underwent video-assisted thoracoscopic (VATS) uniportal lobectomy. Demographic and postoperative data were retrospectively collected and analyzed, focusing on the use of pain medications, in 67 patients of the 140 patients selected by propensity score matching who underwent intubated (iVATS) or non-intubated (NITS) uniportal VATS lobectomy. This study focused on the use of analgesic medications 3, 6, and 12 months after surgery. Thirty-five intubated and 32 non-intubated patients were compared. Although the analgesic consumption was nearly 2% higher among the iVATS patients during the follow-up period, there were no statistically significant differences at 3 months (15.6 vs. 17.1%) (p = 0.868), at 6 months (9.4 vs. 12.4%) (p = 0.785), and at 12 months (3.3 vs. 5.9%) (p = 0.633) between the NITS and iVATS groups, respectively. More female than male patients reported chronic pain, but the difference was not statistically significant (p = 0.616). Diabetes mellitus was a statistically significant cofactor associated with chronic pain (p = 0.03), while cardiac disease (p = 0.6), perioperative morbidity (p = 0.228), prolonged air leak (p = 0.057), and repeat drainage (p = 0.626) were not. Our study suggests that after non-intubation VATS lobectomies, the postoperative pain was less at 3, 6, and 12 months in NITS patients compared to iVATS patients. The 2% difference was not significant, so it may not be appropriate to claim the advantages of NITS in terms of postoperative pain.

Electrocardiograms Do Not Detect Myocardial Ischemia in Patients With Williams Syndrome and Nonsyndromic Elastin Arteriopathy With Coronary Artery Stenosis

Coronary artery stenosis (CAS) may affect up to 27% of patients with Williams syndrome (WS), which may lead to myocardial ischemia. Patients with WS face a 25- to 100-fold greater risk of sudden cardiac death, frequently linked to anesthesia. Assessing CAS requires either imaging while under general anesthesia or intraoperative assessment, with the latter considered the gold standard. Our study aimed to identify electrocardiogram (ECG) markers of myocardial ischemia in patients with WS or nonsyndromic elastin arteriopathy and documented CAS. We retrospectively reviewed patients with WS/elastin arteriopathy who underwent supravalvar aortic stenosis surgery and CAS assessment from January 1, 2006 to April 30, 2021. A pediatric electrophysiologist, not aware of the patients' CAS status, reviewed their preoperative ECGs for markers of ischemia. We assessed associations of study parameters using Wilcoxon rank-sum and Fisher's exact tests. Of 34 patients, 62% were male, with a median age of 20 months (interquartile range: 8 to 34). CAS was present in 62% (21 of 34), 76% of whom (16 of 21) were male. There were no ECG indicators of myocardial ischemia in patients with CAS. In conclusion, CAS was present in >1/2 the children with WS/elastin arteriopathy who underwent repair of supravalvar aortic stenosis. CAS in WS/nonsyndromic elastin arteriopathy does not appear to exhibit typical ECG-detectable myocardial ischemia. ECGs are not a useful screening tool for CAS in WS/elastin arteriopathy. Given the high anesthesia-related cardiac arrest risk, other noninvasive indicators of CAS are needed.

Delaying Anesthesia Assessment Time Can Put Traumatic Patients at Risk

The Article Abstract is not available.

Educating Family Physician Residents for Anesthetic Preoperative Evaluation and Assessment.

Encounters for preoperative assessments are common within primary care offices, so it is imperative that family medicine residents learn how to perform preoperative evaluations. We assessed family medicine residents' knowledge of preoperative evaluation in preparation for surgery by providing a pre- and post-test alongside a didactic seminar. A didactic seminar on preoperative evaluations was presented at a family medicine resident didactics session by two senior anesthesiology residents. A 16-question, multiple choice test was used as both a pre-test and post-test to assess family medicine residents' knowledge. A total of 31 participants took the pre-test (residents = 24; medical students = 7), and 30 participants took the post-test (residents = 23; medical students = 7). Mean scores and standard deviations were calculated for both tests with an average score of 37.50% ± 10.58% and 45.42% ± 11.12% on the pre- and post-test, respectively. Using the Kruskal-Wallis test, residents showed a significant improvement in test scores following the didactic presentation (p = 0.041), while overall results (residents and medical students) also reported a significant difference (p = 0.004). Our results demonstrated that educating family medicine residents and medical students on preoperative evaluation showed significant, quantifiable gains in knowledge following a brief didactic presentation. Given the current gap between guidelines and practice, our results emphasize the need for a formal medical school and residency-based curriculum related to preoperative patient evaluation.

Pulmonary hypertension: Key aspects in preoperative management

Pulmonary hypertension, characterized by increased pressure in the pulmonary vasculature, can stem from various causes. This condition strains the thin-walled right ventricle of the heart, leading to potential dilation and reduced function over time. Anesthesiologists encounter challenges when managing PH patients during surgery, as the right ventricle poorly responds to inotropic support and undergoes additional stress from surgical conditions. Pulmonary hypertension requires multidisciplinary management in the perioperative setting to ensure appropriate and safe care of patients.Ensuring safe anesthesia for patients with pulmonary hypertension entails careful planning, including a thorough history and physical examination, preoperative testing, optimization of the disease and comorbidities, and comprehensive risk assessment. It is crucial to identify signs and symptoms of progressing pulmonary hypertension and right heart dysfunction. Symptomatic patients with undiagnosed pulmonary hypertension will benefit from referrals to specialists for further evaluation and testing.Diagnostic tools such as electrocardiograms, echocardiography, and right heart catheterization offer valuable information for anesthetic planning and risk assessment. They provide insight into the severity of pulmonary hypertension. Right heart catheterization allows direct measurement of hemodynamic parameters, guiding treatment decisions. Hemodynamic classification distinguishes between pre-capillary, post-capillary, and combined pre- and post-capillary pulmonary hypertension. Another categorization method is clinical grouping based on underlying pathological characteristics, which helps tailor management and treatment choices.This article underscores the significance of perioperative management and the need for a comprehensive evaluation and multidisciplinary approach in patients with pulmonary hypertension. It provides valuable information for anesthesiologists and other healthcare professionals involved in the care of these patients, with a focus on preoperative assessment, risk stratification, and treatment considerations.

Efficacy of spinal anesthesia—ultrasound guided versus landmark-based, in patients undergoing spinal anesthesia: a prospective cross-sectional study

Abstract Objective: This research aims to assess the effectiveness and practical value of ultrasound imaging (US group) in minimizing the discomfort and potential hazards associated with spinal anesthesia compared to traditional landmark-based (LM group) approaches. Materials and Methods: In this prospective, randomized comparative investigation, 80 patients were enrolled to undergo spinal anesthesia using either the landmark-based or ultrasound-guided method, with an equal distribution of 40 patients in each respective group. The study recorded various parameters, including evaluation duration, count of needle insertion attempts, instances of redirection, duration of spinal anesthesia, overall procedure time (comprising assessment and administration of spinal anesthesia), and measurement of intrathecal space depth. Patient comfort was evaluated employing a visual analog scale (VAS). Results: Demographic characteristics, including age, gender, and body mass index, exhibited no notable differences. The overall procedure time was approximately 2–3 min for the LM group and 3–4 min for the US group, with a statistically significant difference (P &lt; 0.0001). The initial successful needle insertion rate was considerably more critical in the US group (52.5%) than in the LM group (10%). The distance from the skin to the subarachnoid space was notably more remarkable in the US group, with a statistically significant distinction from the LM group (P = 0.034). The successful spinal needle placement rate was 77.5% in the US group, significantly surpassing the LM group’s rate of 25% (P &lt; 0.05). Regarding patient comfort assessed using the VAS, the US group demonstrated significantly greater comfort levels than the LM group. In the US group, every patient reported a VAS score of &lt;4, whereas only 27.5% achieved the same level of comfort in the LM group. Conclusion: Our study provides evidence supporting the utility of pre-procedural ultrasound evaluation of the subarachnoid space as an effective tool for achieving successful lumbar punctures in patients receiving spinal anesthesia. Compared to the traditional landmark technique, this approach reduces the number of attempts required while enhancing patient comfort.