Paramedian Incidence Angles in Spinal Anaesthesia
For patients and families
In plain language
An automatic summary of structured registry data. It is an orientation aid, not a substitute for the official protocol or a physician assessment.
- What is being studied
- The protocol lists: Measurement of needle insertion angles.
- Who it may be relevant to
- Registry conditions: Anesthesia; Adverse Effect, Spinal and Epidural. Basic parameters: No limits · All.
- What needs checking
- Age, condition and sex are only basic indicators. Prior treatment, laboratory values and other mandatory requirements appear in the eligibility criteria below.
- Where it takes place
- Spain
- Next step
- Save the trial, show it to the treating physician, and confirm current recruitment with the study center. Costs, documents and travel →
Unsure about the terms? Read our patient guide →
Overview
The objective here is to quantify the number of punctures and redirections during routine practice in the anesthesiology department, verify the final angle of incidence and the sac-skin distance by ultrasound, and determine the optimal, maximum, and minimum angles that would have allowed successful punctures. The objective is also to correlate ultrasound and plain X-ray distances, if available. These angles would then be inferred in advance in patients who must undergo spinal anesthesia, assessing whether this prior estimate reduces the number of punctures and redirections.
Detailed description
Protractors and visual guides may be used to guide the exact insertion angle according to the skin-to-dural sac distance or depending on the skin-to-transverse process distance when the midline approach is not feasible.
Interventions
- Other Measurement of needle insertion angles
Individualization of needle insertion angle depending on the skin to dural sac distance by means of visual guides and adapted protractors
Primary outcome measures
- Number of needle insertion attempts [Time frame: From September 2025 to september 2026.]
Secondary outcome measures (1)
- Number of needle redirections [Time frame: From september 2025 to september 2028]
Eligibility criteria
Inclusion Criteria: patients submitted to spinal anaesthesia -
Exclusion Criteria: none
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Criteria are shown verbatim from the registry (in English). Final eligibility is always assessed by the study center.
Healthy volunteers: Yes
Study design
- Observational model
- Other
Study locations
Spain · 1 center
- APuigdellivolSanchez — Barcelona
Publications
- Puigdellivol-Sanchez A, Reina MA, Sala-Blanch X, Pomes-Tallo J, Prats-Galino A. Pythagoras and Cosines: The skin-dural sac distance and optimal angles in paramedian spinal anesthesia. Clin Anat. 2016 Nov;29(8):1046-1052. doi: 10.1002/ca.22792. Epub 2016 Oct 6. PMID 27598547
- Kim Y, Yoo S, Park SK, Bae H, Lim YJ, Kim JT. Optimal angle of needle insertion for spinal anesthesia in patients with spondylolisthesis: an ultrasonographic study. BMC Anesthesiol. 2021 Sep 8;21(1):221. doi: 10.1186/s12871-021-01444-0. PMID 34496754
- Puigdellivol-Sanchez A, Labandeyra H, Prats-Galino A, Sala-Blanch X. The Transverse Process as a Landmark for Estimating Dural Sac Depth and Feasible Planes for Optimized Paramedian Needle Insertions. NeuroSci. 2025 Nov 21;6(4):119. doi: 10.3390/neurosci6040119. PMID 41283308
- Labandeyra H, Sala-Blanch X, Prats-Galino A, Puigdellivol-Sanchez A. Neuraxial Anesthesia and Risk of Root Damage: A 3D Ex Vivo Study. NeuroSci. 2024 Dec 3;5(4):623-634. doi: 10.3390/neurosci5040044. PMID 39728676
Identifiers
NCT: NCT07210892 · HCB/2018/1236