scholarly journals Real-time ultrasound-guided paramedian spinal anaesthesia: evaluation of the efficacy and the success rate of single needle pass

2017 ◽  
Vol 118 (5) ◽  
pp. 799-801 ◽  
Author(s):  
S.E. Chong ◽  
A. Mohd Nikman ◽  
A. Saedah ◽  
W.H. Wan Mohd Nazaruddin ◽  
Y.C. Kueh ◽  
...  
Keyword(s):  
Success Rate ◽  
Real Time ◽  
Spinal Anaesthesia ◽  
Ultrasound Guided ◽  
Needle Pass

Real-time Ultrasound-Guided Lumbar Epidural with Transverse Interlaminar View: Evaluation of an In-Plane Technique

Pain Medicine ◽  
2019 ◽  
Vol 20 (9) ◽  
pp. 1750-1755 ◽  
Author(s):  
Hesham Elsharkawy ◽  
Wael Saasouh ◽  
Rovnat Babazade ◽  
Loran Mounir Soliman ◽  
Jean-Louis Horn ◽  
...  
Keyword(s):  
Success Rate ◽  
Real Time ◽  
Epidural Anesthesia ◽  
Needle Insertion ◽  
Adult Patients ◽  
Epidural Needle ◽  
Anatomical Landmarks ◽  
Care Hospital ◽  
Open Prostatectomy ◽  
Ultrasound Guided

Abstract Objective The anatomical landmarks method is currently the most widely used technique for epidural needle insertion and is faced with multiple difficulties in certain patient populations. Real-time ultrasound guidance has been recently used to aid in epidural needle insertion, with promising results. Our aim was to test the feasibility, success rate, and satisfaction associated with a novel real-time ultrasound-guided lumbar epidural needle insertion in the transverse interlaminar view. Design Prospective descriptive trial on a novel approach. Setting Operating room and preoperative holding area at a tertiary care hospital. Subjects Adult patients presenting for elective open prostatectomy and planned for surgical epidural anesthesia. Methods Consented adult patients aged 30–80 years scheduled for open prostatectomy under epidural anesthesia were enrolled. Exclusion criteria included allergy to local anesthetics, infection at the needle insertion site, coagulopathy, and patient refusal. A curvilinear low-frequency (2–5 MHz) ultrasound probe and echogenic 17-G Tuohy needles were used by one of three attending anesthesiologists. Feasibility of epidural insertion was defined as a 90% success rate within 10 minutes. Results Twenty-two patients were enrolled into the trial, 14 (63.6%) of whom found the process to be satisfactory or very satisfactory. The median time to perform the block was around 4.5 minutes, with an estimated success rate of 95%. No complications related to the epidural block were observed over the 48 hours after the procedure. Conclusions We demonstrate the feasibility of a novel real-time ultrasound-guided epidural with transverse interlaminar view.

scholarly journals Real-time ultrasound-guided vs. anatomical landmark-guided paramedian epidural anesthesia in overweight parturients undergoing analgesic labor: a randomized controlled trial

2021 ◽  
Keyword(s):  
Success Rate ◽  
Real Time ◽  
Epidural Anesthesia ◽  
Anatomical Landmark ◽  
Ultrasound Guided ◽  
Intervertebral Space ◽  
Puncture Site ◽  
Change Rate ◽  
Procedure Duration ◽  
Total Procedure

We evaluated whether real-time ultrasound-guided epidural block is more suitable for overweight parturients undergoing analgesic labor than traditional palpation positioning. Sixty overweight at-term pregnant women (body mass index ≥30 kg/m2) with singleton pregnancy, prepared for vaginal delivery with epidural analgesia, were randomly allocated into two groups. The parturients in the anatomical landmark catheterization group received paramedian epidural anesthesia using the anatomical landmark-guided technique, while real-time ultrasound-guided positioning was performed in the ultrasound-guided-catheterization group. Total procedure duration, time to identify the puncture site and perform the puncture, first attempt success rate, number of attempts, number of needle-redirections, intervertebral-space-change rate, satisfaction score, and complications were compared between the groups. Procedure duration and time to identify the puncture site were significantly shorter in the anatomical landmark catheterization group (440.1 ± 97.2 s vs. 521.9 ± 68.4 s, p < 0.001 and 24.9 ± 13.6 s vs. 112.2 ± 15.6 s, p < 0.001, respectively). There was no significant difference in the time to perform the puncture (385.3 ± 89.7 s vs. 365.1 ± 73.0 s, p = 0.341). The first attempt success rate was lower while the number of attempts and number of needle-redirections were higher in the anatomical landmark catheterization group (p < 0.05). The intervertebral-space-change rate was similar across the groups. Satisfaction was significantly lower in the ultrasound-guided catheterization group (p = 0.009). Complication occurrence, e.g., catheterization difficulty or bleeding during catheterization, dural puncture, and lower-back pain, was similar across the groups. Real-time ultrasound-guided paramedian epidural anesthesia improved the first attempt success rate and reduced the number of attempts and number of needle-redirections in overweight parturients undergoing analgesic labor. However, the longer total procedure duration and time to identify the puncture site might dissatisfy parturients.

scholarly journals Application of Intelligent Ultrasound in Real-Time Monitoring of Postoperative Analgesic Nerve Block

2021 ◽  
Vol 2021 ◽  
pp. 1-6
Author(s):  
Zhengwei Li ◽  
Ling Zhao ◽  
Wutao Wang ◽  
Ling Zheng
Keyword(s):  
Brachial Plexus ◽  
Success Rate ◽  
Real Time ◽  
Nerve Block ◽  
Postoperative Analgesia ◽  
Nerve Stimulator ◽  
Ultrasound Guided ◽  
Intelligent Monitoring ◽  
Average Success Rate ◽  
Plexus Block

In order to monitor the effect of nerve block in postoperative analgesia more accurately, this paper puts forward the application research of ultrasonic real-time intelligent monitoring of nerve block in postoperative analgesia. Ultrasonic real-time intelligent monitoring of nerve block in upper limb surgery, lower limb surgery, and abdominal surgery combined with the nerve stimulator. The experiments show that there are 5 cases of adverse reactions when the nerve stimulator is only used, but no adverse reactions occur when combined with ultrasound-guided block. Continuous subclavian brachial plexus block with the ultrasound-guided nerve stimulator can clearly see the subclavian brachial plexus and its surrounding tissue structure, the direction of needle insertion in the plane, and the diffusion of narcotic drugs. The average success rate of block was up to 95.2%, which was significantly higher than that of nerve stimulator alone, and the success rate of recatheterization after the first failure was also improved. The average postoperative analgesia satisfaction was 85.6%, the average operation time was only 20 min, and the subclavian artery and pleura were avoided effectively. No pneumothorax and other complications occurred. The average success rate of ultrasound-guided subclavicular brachial plexus block in 1-2-year-old children was 97%, which was much higher than the average success rate of nerve stimulator localization with 63%. Ultrasound-guided nerve block not only directly blocks nerves under visual conditions but also helps to observe the structures around nerves and dynamically observe the diffusion of local anesthetics, which can significantly improve the accuracy and success rate of nerve block and reduce the incidence of complications.

scholarly journals Real-time ultrasound-guided spinal anaesthesia vs pre- procedural ultrasound-guided spinal anaesthesia in obese patients

2021 ◽  
Vol 65 (5) ◽  
pp. 356
Author(s):  
ParliRaghavan Ravi ◽  
Sudarshan Naik ◽  
MukundC Joshi ◽  
Seema Singh
Keyword(s):  
Real Time ◽  
Spinal Anaesthesia ◽  
Obese Patients ◽  
Ultrasound Guided

scholarly journals Comparison of landmark and real-time ultrasound-guided epidural catheter placement in the pediatric population: a prospective randomized comparative trial

2021 ◽  
Author(s):  
Tanya Mital ◽  
Manoj Kamal ◽  
Mritunjay Kumar ◽  
Rakesh Kumar ◽  
Pradeep Bhatia ◽  
...  
Keyword(s):  
Success Rate ◽  
Real Time ◽  
Epidural Catheter ◽  
Epidural Space ◽  
Pediatric Population ◽  
Comparative Trial ◽  
Epidural Needle ◽  
Ultrasound Guided ◽  
Significant Difference ◽  
The Us

Background: Epidural block placement in pediatric patients is technically challenging for anesthesiologists. The use of ultrasound (US) for the placement of an epidural catheter has shown promise. We compared landmark-guided and US-guided lumbar or lower thoracic epidural needle placement in pediatric patients.Methods: This prospective, randomized, comparative trial involved children aged 1–6 years who underwent abdominal and thoracic surgeries. Forty-five children were randomly divided into two groups using a computer-generated random number table, and group allocation was performed by the sealed opaque method into either landmark-guided (group LT) or real-time ultrasound-guided (group UT) epidural placement. The primary outcome was a comparison of the procedure time (excluding US probe preparation). Secondary outcomes were the number of attempts (re-insertion of the needle), bone contacts, needle redirection, skin-to-epidural distance using the US in both groups, success rate, and complications.Results: The median (interquartile range [IQR]) time to reach epidural space was 105.5 (297.0) seconds in group LT and 143.0 (150) seconds in group UT; P = 0.407). While the first attempt success rate was higher in the UT group (87.0% in UT vs. 40.9% in LT; P = 0.004), the number of bone contacts, needle redirections, and procedure-related complications were significantly lower. Conclusions: The use of US significantly reduced needle redirection, number of attempts, bone contact, and complications. There was no statistically significant difference in the time to access the epidural space between the US and landmark technique groups.

Study on Clinical Application of Different Ultrasound-Guided Planar Techniques in Minimally Invasive Percutaneous Nephrolithotomy

2021 ◽  
pp. 155335062199779
Author(s):  
Difu Fan ◽  
Leming Song ◽  
Monong Li ◽  
Chunxiang Luo ◽  
Xiaohui Liao ◽  
...  
Keyword(s):  
Minimally Invasive ◽  
Real Time ◽  
Clinical Application ◽  
Short Axis ◽  
Ultrasound Guided ◽  
Out Of Plane ◽  
Minimally Invasive Percutaneous Nephrolithotomy ◽  
Plane Group ◽  
Plane Technique ◽  
Guided Puncture

Objective. The objective is to explore the clinical application value of ultrasound long- and short-axis planar technology in real-time guided puncture in minimally invasive percutaneous nephrology. Methods. The clinical data of 80 patients undergoing real-time ultrasound-guided minimally invasive percutaneous nephrolithotomy from September 2018 to October 2019 were analyzed. The patients were randomly divided into 2 groups with different ultrasound-guided puncture techniques, long-axis in-plane technique and short-axis out-of-plane technique. Results. Minimally invasive percutaneous nephrolithotomies under real-time ultrasound guidance were successfully completed in both groups of patients. The success rate of the first puncture in the short-axis out-of-plane group was significantly higher than that in the long-axis in-plane group, and the differences were statistically significant ( P <.05); the total puncture time in the short-axis out-of-plane group was significantly less than the long-axis in-plane group, and the differences were statistical significance ( P <.05); there was no significant difference in the single-stage stone removal rate, total percutaneous renal channels, total hospital stay, and rate of complications by the Clavien classification between the 2 groups ( P > .05). Conclusion. Ultrasound long-axis and short-axis planar technologies can achieve good clinical application results in real-time guided puncture to establish percutaneous renal channels during minimally invasive percutaneous nephrolithotomy. Compared with the long-axis in-plane technique, the short-axis out-of-plane technique can shorten the puncture time and improve the success rate of the first puncture.

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