Real-Time Ultrasound-Guided Spinal Anaesthesia: A Prospective Observational Study of a New Approach
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 s...
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| Format: | Article |
| Language: | English |
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Wiley
2013-01-01
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| Series: | Anesthesiology Research and Practice |
| Online Access: | http://dx.doi.org/10.1155/2013/525818 |
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| author | P. H. Conroy C. Luyet C. J. McCartney P. G. McHardy |
| author_facet | P. H. Conroy C. Luyet C. J. McCartney P. G. McHardy |
| author_sort | P. H. Conroy |
| collection | DOAJ |
| description | 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. |
| format | Article |
| id | doaj-art-47179af0f31e411294c15231147b16f2 |
| institution | Kabale University |
| issn | 1687-6962 1687-6970 |
| language | English |
| publishDate | 2013-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Anesthesiology Research and Practice |
| spelling | doaj-art-47179af0f31e411294c15231147b16f22025-02-03T06:07:35ZengWileyAnesthesiology Research and Practice1687-69621687-69702013-01-01201310.1155/2013/525818525818Real-Time Ultrasound-Guided Spinal Anaesthesia: A Prospective Observational Study of a New ApproachP. H. Conroy0C. Luyet1C. J. McCartney2P. G. McHardy3Department of Anaesthesia, Adelaide and Meath National Children’s Hospital, Tallaght, Dublin, IrelandUniversitätsklinik für Anästhesiologie und Schmerztherapie, Inselspital, Bern University Hospital, 3010 Bern, SwitzerlandDepartment of Anesthesia, Sunnybrook Health Sciences Centre, Room M3-200, 2075 Bayview Avenue, Toronto, ON, M4N 3M5, CanadaDepartment of Anesthesia, Sunnybrook Health Sciences Centre, Room M3-200, 2075 Bayview Avenue, Toronto, ON, M4N 3M5, CanadaIdentification 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.http://dx.doi.org/10.1155/2013/525818 |
| spellingShingle | P. H. Conroy C. Luyet C. J. McCartney P. G. McHardy Real-Time Ultrasound-Guided Spinal Anaesthesia: A Prospective Observational Study of a New Approach Anesthesiology Research and Practice |
| title | Real-Time Ultrasound-Guided Spinal Anaesthesia: A Prospective Observational Study of a New Approach |
| title_full | Real-Time Ultrasound-Guided Spinal Anaesthesia: A Prospective Observational Study of a New Approach |
| title_fullStr | Real-Time Ultrasound-Guided Spinal Anaesthesia: A Prospective Observational Study of a New Approach |
| title_full_unstemmed | Real-Time Ultrasound-Guided Spinal Anaesthesia: A Prospective Observational Study of a New Approach |
| title_short | Real-Time Ultrasound-Guided Spinal Anaesthesia: A Prospective Observational Study of a New Approach |
| title_sort | real time ultrasound guided spinal anaesthesia a prospective observational study of a new approach |
| url | http://dx.doi.org/10.1155/2013/525818 |
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