Real-time ultrasound-guided spinal anaesthesia: a prospective observational study of a new approach

Conroy, P. H.; Luyet, Cédric; McCartney, C. J.; McHardy, P. G. (2013). Real-time ultrasound-guided spinal anaesthesia: a prospective observational study of a new approach. Anesthesiology research and practice, 2013, p. 525818. Cairo (Egypt): Hindawi Publishing Corporation 10.1155/2013/525818

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Identification of the subarachnoid space has traditionally been achieved by either a blind landmark-guided approach or using prepuncture ultrasound assistance. To assess the feasibility of performing spinal anaesthesia under real-time ultrasound guidance in routine clinical practice we conducted a single center prospective observational study among patients undergoing lower limb orthopaedic surgery. A spinal needle was inserted unassisted within the ultrasound transducer imaging plane using a paramedian approach (i.e., the operator held the transducer in one hand and the spinal needle in the other). The primary outcome measure was the success rate of CSF acquisition under real-time ultrasound guidance with CSF being located in 97 out of 100 consecutive patients within median three needle passes (IQR 1-6). CSF was not acquired in three patients. Subsequent attempts combining landmark palpation and pre-puncture ultrasound scanning resulted in successful spinal anaesthesia in two of these patients with the third patient requiring general anaesthesia. Median time from spinal needle insertion until intrathecal injection completion was 1.2 minutes (IQR 0.83-4.1) demonstrating the feasibility of this technique in routine clinical practice.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of Intensive Care, Emergency Medicine and Anaesthesiology (DINA) > Clinic and Policlinic for Anaesthesiology and Pain Therapy

UniBE Contributor:

Luyet, Cédric

ISSN:

1687-6962

Publisher:

Hindawi Publishing Corporation

Language:

English

Submitter:

Jeannie Wurz

Date Deposited:

04 Oct 2013 14:33

Last Modified:

23 Jan 2018 12:16

Publisher DOI:

10.1155/2013/525818

PubMed ID:

23365568

BORIS DOI:

10.7892/boris.13010

URI:

https://boris.unibe.ch/id/eprint/13010 (FactScience: 219511)

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