Document Detail


Ultrasound control for presumed difficult epidural puncture.
MedLine Citation:
PMID:  11421838     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: The efficacy of epidural anaesthesia depends on the accurate identification of the epidural space (ES). Abnormal anatomical conditions may make the procedure difficult or impossible. The aim of this study was to investigate whether pre-puncture ultrasound examination of the spinal anatomy might be beneficial in expected cases of difficult epidural anaesthesia. METHODS: We used digital ultrasound equipment with a 5-MHz transducer to assess the anatomy of the ES and the posterior parts of the spinal column. We examined 72 parturients with abnormal anatomical conditions who were scheduled for epidural anaesthesia. The women were randomised into two equal groups. In all patients, the standard loss of resistance technique was used. In the ultrasound group, an ultrasound examination of the appropriate spinal region was conducted prior to epidural puncture. ES depth seen on the ultrasound images was compared to the ES depth measured by the needle. We compared the number of puncture attempts with the standard method (control group) to the number of attempts under ultrasound guidance. RESULTS: Ultrasonography significantly improved operating conditions for epidural anaesthesia. The maximum VAS scores and patient acceptance were significantly better. CONCLUSIONS: With ultrasound measurement of the ES depth, the quality of epidural anaesthesia was enhanced.
Authors:
T Grau; R W Leipold; R Conradi; E Martin
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Publication Detail:
Type:  Clinical Trial; Journal Article; Randomized Controlled Trial    
Journal Detail:
Title:  Acta anaesthesiologica Scandinavica     Volume:  45     ISSN:  0001-5172     ISO Abbreviation:  Acta Anaesthesiol Scand     Publication Date:  2001 Jul 
Date Detail:
Created Date:  2001-06-25     Completed Date:  2001-09-20     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  0370270     Medline TA:  Acta Anaesthesiol Scand     Country:  Denmark    
Other Details:
Languages:  eng     Pagination:  766-71     Citation Subset:  IM    
Affiliation:
Department of Anaesthesiology, University of Heidelberg, Germany. thomas.grau@med.uni-heidelberg.de
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MeSH Terms
Descriptor/Qualifier:
Adult
Anesthesia, Epidural / methods*
Anesthesia, Obstetrical / methods*
Epidural Space / ultrasonography*
Female
Humans
Needles
Pain Measurement
Pregnancy
Skin / ultrasonography

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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