AI Article Synopsis
- The study evaluated the use of neuraxial ultrasound (US) for guiding cervical epidural access, focusing on its effectiveness, failure rate, and complications.
- The research involved 21 participants and assessed ultrasound image quality, depth measurement of the epidural space, and post-procedure confirmation of catheter placement, using various statistical methods for analysis.
- Results showed that US improved visualization and reduced failure rates and complications compared to traditional techniques, indicating that US is a valuable tool for epidural procedures.
Article Abstract
Background: Neuraxial ultrasound (US), a newer modality, can be used for neuraxial imaging, helping in visualizing and aiding in epidural space catheterization. The aim of this study was to evaluate the efficacy of the US for cervical epidural access and to determine the failure rate and complication associated with this technique.
Methods: A prospective single-arm pilot study was conducted on 21 participants. The neuraxial US image quality assessment by Ultrasound Visibility Score (UVS), epidural space depth measurement by US and by conventional loss of resistance (LOR) technique, and post-procedure epidural catheter confirmation by real-time US were the study parameters. Any procedural complications or failure rate were recorded. The Kolmogorov-Smirnov test, paired-samples t-test, and Chi-square test were used for the statistical comparison.
Results: The pre-procedural UVS by the transverse interlaminar view (x/21) was 2.81 ± 1.94 and by the oblique paramedian sagittal view was 16.66 ± 2.39 with UVS being best in the paramedian oblique sagittal view (P- value < 0.05). The comparison of depth of the epidural space identified by USG and that by the LOR technique was statistically insignificant (P = 0.83). The average puncture attempts were 1.1 ± 0.3. Post-procedure US epidural catheter confirmation score (x/3) was 1.44 ± 0.44 with either epidural space expansion or microbubbles seen or both.
Conclusion: The pilot study has successfully demonstrated the implication of US for visualizing and aiding in epidural space catheterization. Also, the failure rate and procedural complications were drastically minimized with the help of US as compared to the traditional blind technique.
Download full-text PDF |
Source |
|---|---|
| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC10691571 | PMC |
| http://dx.doi.org/10.4103/aca.aca_40_23 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Novel bimanual haptic simulator for epidural loss-of-resistance detection: a pilot study assessing movement strategies and performance across anesthesiologist experience levels.
Int J Obstet Anesth
December 2024
Department of Biomedical Engineering and the School of Brain Sciences and Cognition, Ben Gurion University of the Negev, Beer Sheva, Israel.
Background: Correct identification of the epidural space requires extensive training for technical proficiency. This study explores a novel bimanual haptic simulator designed for the precise insertion of an epidural needle based on loss-of-resistance (LOR) detection, providing realistic dual-hand force feedback.
Methods: The simulator, equipped with two haptic devices connected to a Tuohy needle and an LOR syringe, was designed to simulate the tissues' resistive forces felt by the user during the procedure, offer anatomical variability and record detailed performance metrics for personalized feedback.
Ultrasound-assisted middle thoracic epidural catheter placement utilizing the most dorsal sites of bilateral transverse process roots as anatomical landmarks: A cadaveric observational study and a clinical randomized controlled trial.
J Clin Anesth
January 2025
Department of Anesthesiology, Sapporo Medical University School of Medicine, 291 South 1 West 16, Chuo-ku, Sapporo-shi, Hokkaido 060-8543, Japan.
Study Objective: We developed an innovative method for ultrasound-assisted thoracic epidural catheter placement and assessed its potential to reduce procedural duration for trainees.
Design: A cadaveric observational study and a clinical randomized controlled trial.
Setting: Sapporo Medical University Hospital.
Comparative study of labour analgesia onset with injection of loading dose through epidural needle versus catheter: A prospective, double-blinded, randomised clinical trial.
Eur J Anaesthesiol
February 2025
From the Department of Anesthesia, Women's Hospital, Zhejiang University School of Medicine, Hangzhou, China (XC, YT, QY, LS, HL, LW, CJ, XC).
Background: Rapid onset of epidural analgesia is an important concern for the parturient. Commonly, the local anaesthetic mixture is administered through the epidural catheter. Drugs administered through the epidural needle might decrease the onset time and enhance the spread of medication within the epidural space.
View Article and Find Full Text PDFA Novel Approach of Ultrasound-Guided Transforaminal Cervical Nerve Root Injection With Fluoroscopic Validation: A Case Report and Technical Illustration.
Cureus
December 2024
Pain and Rehabilitation, Regen Clinic, Taipei, TWN.
Article Synopsis
- Cervical radiculopathies are typically treated with nerve root injections, and this study introduces a new ultrasound-guided technique for better visualization and injection accuracy.
- A 56-year-old patient with chronic C6 radiculopathy received treatment using this method, combining 5% dextrose and vitamin B12, which significantly improved their symptoms.
- The new technique ensures precise needle placement and effective medication spread while minimizing risks and reducing the need for fluoroscopy, lowering radiation exposure and enhancing treatment outcomes.
Persistent Post-dural Puncture Headaches One Year After Lumbar Puncture: A Case Report.
Cureus
November 2024
Department of Internal Medicine, Aga Khan University Hospital, Nairobi, KEN.
Post-dural puncture headaches usually occur when the cerebrospinal fluid (CSF) leaks due to trauma to the dura mater. This often results in spontaneous intracranial hypotension characterized by orthostatic headaches, neck stiffness, and nausea. In this case report, we discuss a 20-year-old male patient who developed symptoms of intracranial hypotension one year following a lumbar puncture.
View Article and Find Full Text PDFWant AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!