Application of ultrasound in obstetric neuraxial anesthesia_West China Medical Journal

Authors：

ZHOU Jieshu ,  NI Juan

Department of Anesthesiology, West China Second University Hospital, Sichuan University/Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Chengdu, Sichuan 610041, P. R. China;

Corresponding author：

NI Juan, Email: nijuankiki@163.com

Keywords：

Ultrasound; Obstetric anesthesia; Neuraxial anesthesia

DOI：

10.7507/1002-0179.201604261

Video：

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The traditional obstetric neuraxial anesthesia has no visual technical support. The success rate is closely related to the experience of the anesthesiologist, so there is a certain failure rate. With the widespread use of high-resolution portable ultrasound machines in recent years, a large number of clinical studies have upheld the feasibility and effectiveness of ultrasound in neuraxial anesthesia. The application of ultrasound in obstetric neuraxial anesthesia has obvious advantages compared with traditional methods of puncture. Ultrasound can accurately locate the intervertebral space, reduce the number of punctures, enhance the success rate of puncture, enhance the quality of obstetric anesthesia, and increase patients' satisfaction and comfort. This review shows the advantages and limitations of ultrasound in obstetric neuraxial anesthesia.

Citation： ZHOU Jieshu, NI Juan. Application of ultrasound in obstetric neuraxial anesthesia. West China Medical Journal, 2018, 33(5): 623-625. doi: 10.7507/1002-0179.201604261 Copy

1.	Hamandi K, Mottershead J, Lewis T, et al. Irreversible damage to the spinal cord following spinal anesthesia. Neurology, 2002, 59(4): 624-626.
2.	Furness G, Reilly MP, Kuchi S. An evaluation of ultrasound imaging for identification of lumbar intervertebral level. Anaesthesia, 2002, 57(3): 277-280.
3.	Whitty R, Moore M, Macarthur A. Identification of the lumbar interspinous spaces: palpation versus ultrasound. Anesth analg, 1994, 106(2): 538-540.
4.	Schlotterbeck H, Schaeffer R, Dow WA, et al. Ultrasonographic control of the puncture level for lumbar neuraxial block in obstetric anaesthesia. Br J Anaesth, 2008, 100(2): 230-234.
5.	Locks Gde F, Almeida MC, Pereira AA. Use of the ultrasound to determine the level of lumbar puncture in pregnant women. Rev bras Anestesiol, 2010, 60(1): 13-19.
6.	Margarido CB, Mikhael R, Arzola C, et al. The intercristal line determined by palpation is not a reliable anatomical landmark for neuraxial anesthesia. Can J Anaesth, 2011, 58(3): 262-266.
7.	Sahin T, balaban O, Sahin L, et al. A randomized controlled trial of preinsertion ultrasound guidance for spinal anaesthesia in pregnancy: outcomes among obese and lean parturients: ultrasound for spinal anesthesia in pregnancy. J Anesth, 2014, 28(3): 413-419.
8.	Lee AJ, Ranasinghe JS, Chehade JM, et al. Ultrasound assessment of the vertebral level of the intercristal line in pregnancy. Anesth Analg, 2011, 113(3): 559-564.
9.	Niazi AU, Tait G, Carvalho JC, et al. The use of an online three-dimensional model improves performance in ultrasound scanning of the spine: a randomized trial. Can J Anaesth, 2013, 60(5): 458-464.
10.	Stiffler KA, Jwayyed S, Wilber ST, et al. The use of ultrasound to identify pertinent landmarks for lumbar puncture. Am J Emerg Med, 2007, 25(3): 331-334.
11.	Clinkscales CP, Greenfield ML, Vanarase M, et al. An observational study of the relationship between lumbar epidural space depth and body mass index in Michigan parturients. Int J Obstet Anesth, 2007, 16(4): 323-327.
12.	Balki M, Lee Y, Halpern S, et al. Ultrasound imaging of the lumbar spine in the transverse plane: the correlation between estimated and actual depth to the epidural space in obese parturients. Anesth Analg, 2009, 108(6): 1876-1881.
13.	Arzola C, Davies S, Rofaeel A, et al. Ultrasound using the transverse approach to the lumbar spine provides reliable landmarks for labor epidurals. Anesth Analg, 2007, 104(5): 1188-1192.
14.	Grau T, Leipold RW, Fatehi S, et al. Real-time ultrasonic observation of combined spinal-epidural anaesthesia. Eur J Anaesthesiol, 2004, 21(1): 25-31.
15.	Sahota JS, Carvalho JC, Balki M, et al. Ultrasound estimates for midline epidural punctures in the obese parturient: paramedian sagittal oblique is comparable to transverse median plane. Anesth Analg, 2013, 116(4): 829-835.
16.	Wang Q, Yin C, Wang TL. Ultrasound facilitates identification of combined spinal-epidural puncture in obese parturients. Chin Med J(Engl), 2012, 125(21): 3840-3843.
17.	Wallace DH, Currie JM, Gilstrap LC, et al. Indirect sonographic guidance for epidural anesthesia in obese pregnant patients. Reg Anesth, 1992, 17(4): 233-236.
18.	Grau T, leipold RW, conradi R, et al. Efficacy of ultrasound imaging in obstetric epidural anesthesia. J Clin Anesth, 2002, 14(3): 169-175.
19.	Shaikh F, Brzezinski J, Alexander S, et al. Ultrasound imaging for lumbar punctures and epidural catheterisations: systematic review and meta-analysis. BMJ, 2013, 346: f1720.
20.	Grau T, Leipold RW, Conradi R, et al. Ultrasound control for presumed difficult epidural puncture. Acta Anaesthesiol Scand, 2001, 45(6): 766-771.
21.	Vallejo MC, Phelps AL, Singh S, et al. Ultrasound decreases the failed labor epidural rate in resident trainees. Int J Obstet Anesth, 2010, 19(4): 373-378.
22.	Grau T, Bartusseck E, Conradi R, et al. Ultrasound imaging improves learning curves in obstetric epidural anesthesia: a preliminary study. Can J Anaesth, 2003, 50(10): 1047-1050.
23.	Ansari T, Yousef A, El Gamassy A, et al. Ultrasound-guided spinal anaesthesia in obstetrics: is there an advantage over the landmark technique in patients with easily palpable spines?. Int J Obstet Anesth, 2014, 23(3): 213-216.
24.	Perlas A. Evidence for the use of ultrasound in neuraxial blocks. Reg Anesth Pain Med, 2010, 35(2 Suppl): S43-S46.

1. Hamandi K, Mottershead J, Lewis T, et al. Irreversible damage to the spinal cord following spinal anesthesia. Neurology, 2002, 59(4): 624-626.
2. Furness G, Reilly MP, Kuchi S. An evaluation of ultrasound imaging for identification of lumbar intervertebral level. Anaesthesia, 2002, 57(3): 277-280.
3. Whitty R, Moore M, Macarthur A. Identification of the lumbar interspinous spaces: palpation versus ultrasound. Anesth analg, 1994, 106(2): 538-540.
4. Schlotterbeck H, Schaeffer R, Dow WA, et al. Ultrasonographic control of the puncture level for lumbar neuraxial block in obstetric anaesthesia. Br J Anaesth, 2008, 100(2): 230-234.
5. Locks Gde F, Almeida MC, Pereira AA. Use of the ultrasound to determine the level of lumbar puncture in pregnant women. Rev bras Anestesiol, 2010, 60(1): 13-19.
6. Margarido CB, Mikhael R, Arzola C, et al. The intercristal line determined by palpation is not a reliable anatomical landmark for neuraxial anesthesia. Can J Anaesth, 2011, 58(3): 262-266.
7. Sahin T, balaban O, Sahin L, et al. A randomized controlled trial of preinsertion ultrasound guidance for spinal anaesthesia in pregnancy: outcomes among obese and lean parturients: ultrasound for spinal anesthesia in pregnancy. J Anesth, 2014, 28(3): 413-419.
8. Lee AJ, Ranasinghe JS, Chehade JM, et al. Ultrasound assessment of the vertebral level of the intercristal line in pregnancy. Anesth Analg, 2011, 113(3): 559-564.
9. Niazi AU, Tait G, Carvalho JC, et al. The use of an online three-dimensional model improves performance in ultrasound scanning of the spine: a randomized trial. Can J Anaesth, 2013, 60(5): 458-464.
10. Stiffler KA, Jwayyed S, Wilber ST, et al. The use of ultrasound to identify pertinent landmarks for lumbar puncture. Am J Emerg Med, 2007, 25(3): 331-334.
11. Clinkscales CP, Greenfield ML, Vanarase M, et al. An observational study of the relationship between lumbar epidural space depth and body mass index in Michigan parturients. Int J Obstet Anesth, 2007, 16(4): 323-327.
12. Balki M, Lee Y, Halpern S, et al. Ultrasound imaging of the lumbar spine in the transverse plane: the correlation between estimated and actual depth to the epidural space in obese parturients. Anesth Analg, 2009, 108(6): 1876-1881.
13. Arzola C, Davies S, Rofaeel A, et al. Ultrasound using the transverse approach to the lumbar spine provides reliable landmarks for labor epidurals. Anesth Analg, 2007, 104(5): 1188-1192.
14. Grau T, Leipold RW, Fatehi S, et al. Real-time ultrasonic observation of combined spinal-epidural anaesthesia. Eur J Anaesthesiol, 2004, 21(1): 25-31.
15. Sahota JS, Carvalho JC, Balki M, et al. Ultrasound estimates for midline epidural punctures in the obese parturient: paramedian sagittal oblique is comparable to transverse median plane. Anesth Analg, 2013, 116(4): 829-835.
16. Wang Q, Yin C, Wang TL. Ultrasound facilitates identification of combined spinal-epidural puncture in obese parturients. Chin Med J(Engl), 2012, 125(21): 3840-3843.
17. Wallace DH, Currie JM, Gilstrap LC, et al. Indirect sonographic guidance for epidural anesthesia in obese pregnant patients. Reg Anesth, 1992, 17(4): 233-236.
18. Grau T, leipold RW, conradi R, et al. Efficacy of ultrasound imaging in obstetric epidural anesthesia. J Clin Anesth, 2002, 14(3): 169-175.
19. Shaikh F, Brzezinski J, Alexander S, et al. Ultrasound imaging for lumbar punctures and epidural catheterisations: systematic review and meta-analysis. BMJ, 2013, 346: f1720.
20. Grau T, Leipold RW, Conradi R, et al. Ultrasound control for presumed difficult epidural puncture. Acta Anaesthesiol Scand, 2001, 45(6): 766-771.
21. Vallejo MC, Phelps AL, Singh S, et al. Ultrasound decreases the failed labor epidural rate in resident trainees. Int J Obstet Anesth, 2010, 19(4): 373-378.
22. Grau T, Bartusseck E, Conradi R, et al. Ultrasound imaging improves learning curves in obstetric epidural anesthesia: a preliminary study. Can J Anaesth, 2003, 50(10): 1047-1050.
23. Ansari T, Yousef A, El Gamassy A, et al. Ultrasound-guided spinal anaesthesia in obstetrics: is there an advantage over the landmark technique in patients with easily palpable spines?. Int J Obstet Anesth, 2014, 23(3): 213-216.
24. Perlas A. Evidence for the use of ultrasound in neuraxial blocks. Reg Anesth Pain Med, 2010, 35(2 Suppl): S43-S46.

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