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Real-time Ultrasound-guided Spinal Anesthesia Using a New Paramedian Transverse Approach

Abstract

Ultrasound-guided spinal anesthesia is an attracting and advanced technique. We developed a new paramedian transverse approach for real-time ultrasound-guided spinal anesthesia. Using this approach, the block can be performed with the dominant hand whether in right or left lateral decubitus or sitting position. Our preliminary experience in 42 orthopedic and obstetric patients showed it could achieve high first pass success rate with acceptable procedure time. The effectiveness and safety of this approach need further investigation by comparing it with blind technique and other ultrasound-guided techniques with well-designed randomized controlled trials.

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References

  1. Chin KJ, Perlas A, Chan V, et al. Ultrasound imaging facilitates spinal anesthesia in adults with difficult surface anatomic landmarks. Anesthesiology, 2011,115(1):94–101

    Article  PubMed  Google Scholar 

  2. Auyong DB, Hostetter L, Yuan SC, et al. Evaluation of Ultrasound-Assisted Thoracic Epidural Placement in Patients Undergoing Upper Abdominal and Thoracic Surgery: A Randomized, Double-Blind Study. Reg Anesth Pain Med, 2017,42(2):204–209

    Article  PubMed  Google Scholar 

  3. Chin A, Crooke B, Heywood L, et al. A randomised controlled trial comparing needle movements during combined spinal-epidural anaesthesia with and without ultrasound assistance. Anaesthesia, 2018,73(4):466–473

    Article  CAS  PubMed  Google Scholar 

  4. Elsharkawy H, Maheshwari A, Babazade R, et al. Real-time ultrasound-guided spinal anesthesia in patients with predicted difficult anatomy. Minerva Anestesiol, 2017,83(5):465–473

    PubMed  Google Scholar 

  5. Chong SE,Mohd Nikman A, Saedah A, et al. Real-time ultrasound-guided paramedian spinal anaesthesia: evaluation of the efficacy and the success rate of single needle pass. Br J Anaesth, 2017,118(5):799–801

    Article  CAS  PubMed  Google Scholar 

  6. Conroy PH, Luyet C, McCartney CJ, et al. Real-time ultrasound-guided spinal anaesthesia: a prospective observational study of a new approach. Anesthesiol Res Pract, 2013,2013:525818

    CAS  PubMed  PubMed Central  Google Scholar 

  7. Karmakar MK, Li X, Ho AM, et al. Real-time ultrasound-guided paramedian epidural access: evaluation of a novel in-plane technique. Br J Anaesth, 2009,102(6):845–854

    Article  CAS  PubMed  Google Scholar 

  8. Brinkmann S, Tang R, Sawka A, et al. Singleoperator real-time ultrasound-guided spinal injection using SonixGPS: a case series. Can J Anaesth, 2013,60(9):896–901

    Article  PubMed  Google Scholar 

  9. Lee PJ, Tang R, Sawka A, et al. Brief report: real-time ultrasound-guided spinal anesthesia using Taylor's approach. Anesth Analg, 2011,112(5):1236–1238

    Article  PubMed  Google Scholar 

  10. Ghosh SM, Madjdpour C, Chin KJ. Ultrasoundguided lumbar central neuraxial block. Bja Education, 2016,16(7):213–220

    Article  Google Scholar 

  11. Chin KJ, Karmakar MK, Peng P. Ultrasonography of the adult thoracic and lumbar spine for central neuraxial blockade. Anesthesiology, 2011,114(6):1459–1485

    Article  PubMed  Google Scholar 

  12. Barrett NM, Arzola C, Krings T, et al. Lumbar Spine Anatomy in Women Sustaining Unintentional Dural Puncture During Labor Epidural Placement: A Descriptive Study Using Magnetic Resonance Imaging and Ultrasound. Reg Anesth Pain Med, 2018,43(1):92–96

    Article  PubMed  Google Scholar 

  13. Liu SS, McDonald SB. Current issues in spinal anesthesia. Anesthesiology, 2001,94(5):888–906

    Article  CAS  PubMed  Google Scholar 

  14. Narouze SN, Provenzano D, Peng P, et al. The American Society of Regional Anesthesia and Pain Medicine, the European Society of Regional Anaesthesia and Pain Therapy, and the Asian Australasian Federation of Pain Societies Joint Committee recommendations for education and training in ultrasound-guided interventional pain procedures. Reg Anesth Pain Med, 2012,37(6):657–664

    Article  CAS  PubMed  Google Scholar 

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Correspondence to Wei Mei.

Additional information

This report was supported by the Clinical Research Physician Program of Tongji Medical College, HUST.

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Liu, Y., Qian, W., Ke, Xj. et al. Real-time Ultrasound-guided Spinal Anesthesia Using a New Paramedian Transverse Approach. CURR MED SCI 38, 910–913 (2018). https://doi.org/10.1007/s11596-018-1961-7

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  • DOI: https://doi.org/10.1007/s11596-018-1961-7

Key words

  • anesthetic techniques
  • spinal anesthesia
  • subarachnoid
  • ultrasound