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Abstract Ultrasound guidance in neuroaxial blocks was reported to improve the ease of insertion and minimize the traumatic trials. However the data about the use of ultrasound as a real-time guidance periprocedural are scanty. In this study we have done a randomized controlled trial comparing paramedian spinal anesthesia using real time ultrasound guidance with conventional land mark guided technique. Real time ultrasound guidance was found to be associated with fewer puncture attempts, fewer complications and also more patient{u2019}s satisfaction compared to the land mark guided technique |