Real-Time Ultrasound-Guided Spinal Anaesthesia: A Prospective Observational Study of a New Approach
نویسندگان
چکیده
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.
منابع مشابه
Study of Induction Times of Various Anaesthetic Techniques
The aims and objectives of our study is to analyse the time taken by the anaesthetist for induction during general, spinal, combined spinal epidural and ultrasound guided brachial plexus block ,comparing these with benchmark values and find reasons for delay. Present prospective case study aims at measurement of anaesthesia induction times during a period of two months. Overall 231 patients had...
متن کاملRandomized, prospective, observational simulation study comparing residents' needle-guided vs free-hand ultrasound techniques for central venous catheter access.
BACKGROUND Short-axis ultrasound-guided placement of central venous catheters (CVCs) is widely accepted as safe practice. However, utilizing the long-axis approach could further improve safety, as it allows for better visualization of the needle as it is advanced to the target vessel. However, the long-axis approach has not widely been used due to the technical difficulty. Recently, a new needl...
متن کاملReal-time ultrasound-guided paramedian epidural access: evaluation of a novel in-plane technique.
BACKGROUND Current methods of locating the epidural space rely on surface anatomical landmarks and loss-of-resistance (LOR). We are not aware of any data describing real-time ultrasound (US)-guided epidural access in adults. METHODS We evaluated the feasibility of performing real-time US-guided paramedian epidural access with the epidural needle inserted in the plane of the US beam in 15 adul...
متن کاملA RANDOMIZED PROSPECTIVE COMPARATIVE STUDY OF FOUR METHODS OF BICEPS TENDONITIS TREATMENT: ULTRASOUND, LOW LEVEL LASER+ ULTRASOUND, INTRA-SHEAT AND EXTRA-SHEAT CONTICOSTEROID GUIDED INJECTION
This was Presented in 5th International Congress of Iranian Iranian Society of Knee Surgery, Arthroscopy, and Sports Traumatology (ISKAST), 14-17 Feb 2018- Kish, Iran
متن کاملBIS guided sedation with propofol during spinal anaesthesia: influence of anaesthetic level on sedation requirement.
BACKGROUND In this prospective, clinical study we tested the hypothesis whether two different doses of spinal administered bupivacaine and accordingly, two different levels of spinal anaesthesia can affect the dose requirement of propofol during BIS guided sedation. METHODS Fifty women undergoing vaginal hysterectomy (high spinal group, HS) or transvaginal tape (TVT) procedure for urinary inc...
متن کاملذخیره در منابع من
با ذخیره ی این منبع در منابع من، دسترسی به آن را برای استفاده های بعدی آسان تر کنید
عنوان ژورنال:
دوره 2013 شماره
صفحات -
تاریخ انتشار 2013