Real-Time Ultrasound-Guided Spinal Anaesthesia: A Prospective Observational Study of a New ApproachReport as inadecuate




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Anesthesiology Research and PracticeVolume 2013 2013, Article ID 525818, 7 pages

Clinical Study

Department of Anaesthesia, Adelaide and Meath National Children’s Hospital, Tallaght, Dublin, Ireland

Universitätsklinik für Anästhesiologie und Schmerztherapie, Inselspital, Bern University Hospital, 3010 Bern, Switzerland

Department of Anesthesia, Sunnybrook Health Sciences Centre, Room M3-200, 2075 Bayview Avenue, Toronto, ON, Canada M4N 3M5

Received 30 August 2012; Accepted 15 November 2012

Academic Editor: Jean Jacques Lehot

Copyright © 2013 P. H. Conroy et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

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.





Author: P. H. Conroy, C. Luyet, C. J. McCartney, and P. G. McHardy

Source: https://www.hindawi.com/



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