Abstract
Background
Data are scarce on the advantage of ultrasound-guided spinal anaesthesia in patients
with easily identifiable bony landmarks. In this study, we compared the use of ultrasound
to the landmark method in patients with no anticipated technical difficulty, presenting
for caesarean delivery under spinal anaesthesia.
Methods
A total of 150 pregnant women were recruited in this randomized, controlled study.
Ultrasound examination and spinal anaesthesia were performed by three anaesthetists
with experience in ultrasound-guided neuraxial block. Patients were randomized to
either the Ultrasound Group (n = 75) or the Landmark Group (n = 75). In both groups the level of L3–4 or L4–5 was identified by ultrasound (transverse
and longitudinal approach) or palpation. The primary outcome was the procedure time,
measured from the time of skin puncture by the introducer to the time of viewing cerebrospinal
fluid at the hub of the spinal needle. Secondary outcomes were the number of skin
punctures, number of passes, and incidence of successful spinal blockade.
Results
The average procedure time, number of skin punctures and needle passes, were similar
in both groups. The number of patients with successful spinal anaesthesia after one
puncture was not statistically different between the groups.
Conclusion
The present results indicate that when performed by anaesthetists experienced in both
ultrasound and landmark techniques, the use of ultrasound does not appear to increase
the success rate of spinal anaesthesia, or reduce the procedure time or number of
attempts in obstetric patients with easily palpable spines.
Keywords
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Article info
Publication history
Published online: April 24, 2014
Accepted:
March 1,
2014
Identification
Copyright
© 2014 Elsevier Ltd. Published by Elsevier Inc. All rights reserved.
