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Related Concept Videos

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Procedures for Kidney StonesMedical intervention is necessary when kidney stones or renal calculi are too large to pass spontaneously (typically greater than 5 millimeters) when stones are accompanied by symptomatic infection (such as fever or pyelonephritis), when they impair kidney function, or when they cause persistent symptoms like severe pain, nausea, or urinary retention. Additionally, patients with only one kidney or those who cannot be treated with medical management also require...
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Related Experiment Video

Updated: Apr 21, 2026

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Predicting difficulty score for spinal anesthesia in transurethral lithotripsy surgery.

Hossein Khoshrang1, Siavash Falahatkar1, Abtin Heidarzadeh1

  • 1Urology Research Center, School of Medicine, Guilan University of Medical Sciences, Rasht, Iran.

Anesthesiology and Pain Medicine
|October 23, 2014
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Summary

Predicting spinal anesthesia difficulty is crucial for improving patient outcomes. Factors like BMI, lumbar spine characteristics, and deformity significantly influence SA success, aiding anesthesiologists in planning procedures.

Keywords:
LithotripsySeverity ScoreSpinal Anesthesia

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Area of Science:

  • Anesthesiology
  • Regional Anesthesia
  • Surgical Procedures

Background:

  • Spinal anesthesia (SA) is a prevalent regional anesthesia (RA) technique for numerous surgical interventions.
  • Predicting SA difficulty is essential for enhancing anesthesia quality and minimizing complications.

Purpose of the Study:

  • To develop a predictive model for spinal anesthesia difficulty.
  • To identify key patient factors associated with SA procedural difficulty.

Main Methods:

  • An observational study involving 101 Transurethral Lithotripsy (TUL) candidates.
  • Pre-anesthesia assessment included demographic data, BMI, lumbar spine status, and deformity.
  • SA difficulty was categorized based on needle insertion attempts and cerebrospinal fluid visualization.

Main Results:

  • Difficulty in SA was observed in 14.9% of patients.
  • Significant predictors of SA difficulty included lumbar spinous process status, lumbar spine radiological profile, lumbar deformity, and BMI.
  • Receiver Operating Characteristic (ROC) curve analysis identified a cutoff point of 8.5 BMI for predicting difficult SA with 86.7% sensitivity and 86% specificity.

Conclusions:

  • Pre-procedural clinical assessment of lumbar spine characteristics, deformity, and BMI can aid in predicting spinal anesthesia difficulty.
  • This predictive approach can help optimize anesthesia quality and patient safety.