International Surgery Journal | November 2022 | Vol 9 | Issue 11 Page 1857 International Surgery Journal Omodu JO et al. Int Surg J. 2022 Nov;9(11):1857-1860 http://www.ijsurgery.com pISSN 2349-3305 | eISSN 2349-2902 Case Series C-arm fluoroscopic guided subarachnoid block: a single centre experience Jack O. Omodu 1 *, Abiye F. George 2 , Charles D. Mbaba 2 , Felix C. Wekere 3 INTRODUCTION The subarachnoid block is routinely performed blindly by the use of anatomical landmarks in identifying the lumbar interspace using an imaginary line drawn across the highest point of both iliac crests known as Tuffier’s line. 1 Ultrasound imaging is deployed in the localization of the subarachnoid space for spinal anaesthesia. The use of ultrasound has been shown to reduce the number of attempts required in performing a subarachnoid block. 2 Ultrasound is valuable in accessing the subarachnoid space in predicted difficult cases, real-time ultrasound guidance for spinal anaesthesia in challenging patients provided lower needle insertion attempts and patient satisfaction when compared with using the landmark technique. 3,4 This notwithstanding, the use of ultrasound in localization of the subarachnoid space has some setbacks similar to the conventional palpation method, it was observed that accuracy was largely dependent on the observer’s proficiency, even in the hands of the experienced anaesthetist in the use of ultrasound, misinterpretation of the intervertebral levels of the spine has been noted, this is seen in patients with severe spinal deformities and the supra obese. 5 Fluoroscopy is a well-established imaging tool in operating theatres and pain clinics. Performing the procedure using the landmark technique in patients with spinal deformities or morbidly obese can inflict discomfort to the patient from multiple needle pricks or prolonged positioning during the procedure. 5 The use of fluoroscopy in accessing the subarachnoid space has the advantage of showing real-time images and provides accurate visualization of the intervertebral space and needle paths. 6 This article reports the demonstration of the use of c-arm ABSTRACT Subarachnoid block is routinely accessed blindly by the use of anatomical landmarks in the localization of the subarachnoid. Performing the procedure using the landmark technique in patients with spinal deformities or morbidly obese can inflict discomfort to the patient from multiple needle pricks or prolonged positioning during the procedure. This article aims to demonstrate the use of C-arm fluoroscopy for easy and smooth access into the subarachnoid space. This was a retrospective review of all patients who had subarachnoid block with the aid of C-arm fluoroscopy for surgeries involving the pelvis and perineum at Colworths Medical Centre, Port Harcourt from September 2020 to June 2022. Data were collected from the patients records over the period of study, there were seven cases recorded. Of the 7 cases, 5 were males and 2 females. Fluoroscopy allows visualization of the needle path and additionally identifies pathological conditions before needle insertion. Keywords: Fluoroscopy, Subarachnoid block, Spinal anaesthesia, Colworths Medical Centre 1 Colworths Medical Centre, Port Harcourt, Rivers State, Nigeria 2 Department of Anaesthesia, 3 Department of Obstetrics and Gynaecology, Rivers State University Teaching Hospital, Port Harcourt, Rivers State, Nigeria Received: 01 September 2022 Revised: 30 September 2022 Accepted: 15 October 2022 *Correspondence: Dr. Jack O. Omodu, E-mail: gidaug@yahoo.com Copyright: © the author(s), publisher and licensee Medip Academy. This is an open-access article distributed under the terms of the Creative Commons Attribution Non-Commercial License, which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. DOI: https://dx.doi.org/10.18203/2349-2902.isj20222941