Comparison of the Severity of Injection Pain and Success in Spinal Anesthesia of Elderly Patients by Midline and Paramedian Approaches

Abstract The side effects of general anesthesia increase by ageing. Considering the inability of elderly patients to cooperate with anesthesiologist for implementation of spinal anesthesia, this study was conducted to compare the severity of injection pain and success of two methods of spinal anesthesia through midline and paramedian approaches in elderly patients. Background: In this randomized double-blind clinical trial, 100 elderly patients who were candidated for elective surgery under spinal anesthesia,  were randomly assigned into two groups of equal number ; in one group  spinal anesthesia was conducted with midline approach and in the other group with paramedian approach. Data were analyzed with SPSS ver13.0 by using Chi-square, Mann-Whitney U and t-Student tests. Methods: The patients of the two groups had no significant difference in terms of age, weight, height and gender. In the paramedian approach, severity of injection pain was significantly lower than in the midline group (p=0.01). In addition, the first successful trial instances were significantly higher in the paramedian than in the midline approach (36 vs.17 cases, respectively, p