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Spinal Ultrasound Versus Palpation for Epidural Catheter Insertion in Labour

A Randomized-Controlled Trial

Arzola, C.; Mikhael, R.; Margarido, C.; Carvalho, J.C.

Obstetric Anesthesia Digest: June 2016 - Volume 36 - Issue 2 - p 104
doi: 10.1097/01.aoa.0000482641.18808.f8
Anesthesia Analgesia: Regional Analgesia
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(Eur J Anaesthesiol. 2015 Jul;32(7):499–505)

Ultrasound guidance has gained increasing acceptance among anesthesiologist as a means to improve the efficacy and safety of various procedures, including vascular access, peripheral nerve blockade, and neuraxial anesthesia. Although several studies have been published on the use of spinal ultrasound, a common limitation is that a single expert investigator or selected group of anesthesiologists performed the ultrasound scanning while an experienced or novice operator carried out the neuraxial technique, This may affect the generalizability of the existing data and raises the question of whether the same benefits would be observed if clinicians performed both the ultrasound scanning and the neuraxial procedure. This randomized-controlled trial investigated the impact of ultrasound usage on the ease of insertion of labor epidurals by a mixed group of trainees after they participated in a comprehensive teaching program on ultrasound assessment of the spine. The investigators hypothesized that the use of preprocedural spinal ultrasound would improve the ease of insertion of labor epidural catheters when compared with the conventional palpation technique.

Department of Anesthesia and Pain Management, Mount Sinai Hospital (C.A., R.M., J.C.C.), Department of Anesthesia, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, ON, Canada

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