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Does Preprocedural Ultrasound Increase the First-Pass Success Rate of Epidural Catheterization Before Cesarean Delivery? A Randomized Controlled Trial

Tawfik, Mohamed M. MD; Atallah, Magdy M. MD; Elkharboutly, Walaa S. MD; Allakkany, Nasser S. MD; Abdelkhalek, Mostafa MSc

doi: 10.1097/01.aoa.0000504698.59827.1f
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(Anesth Analg 2016) [Epub ahead of print].

Many obstetric studies have compared preprocedural ultrasound for epidural catheterization with the landmark palpation technique and found the former to be safe and efficacious. However, several of these studies were unblinded and had inconsistent designs regarding patient characteristics, single or multiple operator involvement, and operator expertise. The authors of the present study addressed these issues in this double-blind, randomized controlled trial, which compared preprocedural ultrasound with conventional palpation for epidural catheterization performed by a single, experienced anesthesiologist as a component of double-interspace combined spinal-epidural (CSE) anesthesia for cesarean delivery. The primary outcome was the success rate of epidural catheterization at the first needle pass. Secondary outcomes included the success rate of epidural catheterization at the first skin puncture, number of performed needle passes and skin punctures, duration of the epidural procedure, patient satisfaction, and complications.

Department of Anesthesia and Surgical Intensive Care, Mansoura University Hospitals, Mansoura, Egypt

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