Pre-Procedure Neuraxial Ultrasound in Obstetric Anesthesia

Manuel C. Vallejo
Departments of Medical Education and Anesthesiology, West Virginia University School of Medicine, Morgantown, USA.
J Anesth Perioper Med 2018; 5(2): 85- 91 . Published on Jul 24, 2017 . doi:10.24015/JAPM.2017.0050
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Aim of review: To determine the current state of pre-procedure neuraxial ultrasound in obstetric anesthesia practice. 
Method: The PubMed and Scopus databases were searched for the keywords “neuraxial”, or “epidural”, or “spinal” or “ultrasound”, combined with “obstetric anesthesia”. A current review of original studies, systematic reviews, and meta-analysis within the past decade were included in the analysis.  
Recent findings: Pre-procedure ultrasound imaging enhances successful neuraxial placement through determination of the optimal vertebral interspace, identification of the midline, location of the optimal insertion point, best angle for needle insertion, and accurate depth for needle advancement to the epidural or intrathecal space. In the experienced clinician, neuraxial ultrasound imaging can be of particular benefit in parturients with difficult anatomy and/or landmarks.  
Summary: Neuraxial ultrasound imaging reduces the risk of failed or traumatic lumbar punctures and epidural catheterizations, the number of insertion attempts, and needle redirections. 
Citation: Manuel C. Vallejo. Pre-Procedure Neuraxial Ultrasound in Obstetric Anesthesia. J Anesth Perioper Med 2018; 5 : 85-91. doi: 10.24015/ JAPM.2017.0050
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