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Background and Aims: The area of lumbar spinal canal decreases with age, and hence the level of sensory blockade is higher in the elderly after spinal injection. The present study optimised the dose of local anaesthetic in elderly patients based on the lumbar dural sac cross sectional area (DSCSA) determined using ultrasound. Methods: Sixty patients of age above 60 years undergoing transurethral resection of prostrate (TURP) surgery in a tertiary care hospital were included in the study. Patients were categorised into two groups of 30 each based on a computer-generated random number table. In the control group (C), 2 ml of 0.5% hyperbaric bupivacaine was given and in the ultrasound group (U), the drug dose was modified according to DSCSA which was measured using the formula area = p (diameter/2) 2. Results The DSCSA and bupivacaine dosage were significantly lower in group U compared to control group (P = 0.0001). The maximal level of cephalad spread of sensory blockade was significantly lower in ultrasound group, than in control group (P = 0.002). The two-segment block regression time and motor recovery time was less in group U. Higher mean arterial pressure (105.8 ± 9.66 mmHg; P = 0.007), and a lower decrease from baseline (14.15 ± 7.55%; P = 0.041) was noted in group U after subarachnoid block. Conclusion The estimation of DSCSA is an effective parameter and can be used to modify the dose of local anaesthetic for subarachnoid block in elderly patients undergoing TURP surgery.

Introduction: The main aim of this study is to determine if ultrasonography (USG) based measurement of subglottic diameter is the best size predictor for endotracheal tube (ETT) in pediatric surgical cases over age-based formula with micro cuff tube. Also, to test reintubation percentage and post-operative complications in children. Methodology: This research is double-blind randomized control study with 68 children undergoing elective surgery requiring general anaesthesia with micro cuff tube. They were divided into 2 groups i.e. ETT size by USG (group U) and ETT size by age-based formula group A) (with 34 children in each. Both groups ETT measurement was calculated by independent Samples t-test, and correlation of both groups with actual ET Tube was measured by Pearson’s correlation coefficient. Reintubations or post-op complications was measured by Chi-squared test. Results: Mean age of group A and U are 5.65 ± 2.77 and 5.97 ± 2.77 respectively. Mean weights were from 13.5±2.06 kgs to 27±4.63kgs. Statistical significance with a P-value (P=0.0460) is observed in group U whereas no significance was seen in group A. A strong positive correlation (R=0.960) between USG-estimated ETT size and actual ETT size is observed. The difference in reintubations and post-op complications in group U were statistically significant with P < 0.002. Conclusion: The present study concludes that the sub glottis diameter measured by USG is a good predictor for correct size of micro cuff endo tracheal tube in children.