J Anesth Perioper Med. 2018;5(2):85-91. https://doi.org/10.24015/ebcmed.japm.2017.0050

Pre-Procedure Neuraxial Ultrasound in Obstetric Anesthesia

Manuel C. Vallejo

From the Departments of Medical Education and Anesthesiology, West Virginia University School of Medicine, Morgantown, WV, USA.

Correspondence to Dr. Manuel C. Vallejo at mcvallejo@hsc.wvu.edu.

EBCMED ID: ebcmed.japm.2017.0050 DOI: 10.24015/ebcmed.japm.2017.0050


Abstract

Aim of review
To determine the current state of pre-procedure neuraxial ultrasound in obstetric anesthesia practice.

Methods
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.

Conclusion
Neuraxial ultrasound imaging reduces the risk of failed or traumatic lumbar punctures and epidural catheterizations, the number of insertion attempts, and needle redirections. (Funded by the Departments of Medical Education and Anesthesiology, West Virginia University School of Medicine.)

Article Type
Review Article

Declaration of Interests
The author declares no conflicts of interest.

Acknowledgements
This work was supported by the Departments of Medical Education and Anesthesiology, West Virginia University School of Medicine.

This is an open-access article, published by Evidence Based Communications (EBC). This work is licensed under the Creative Commons Attribution 4.0 International License, which permits unrestricted use, distribution, and reproduction in any medium or format for any lawful purpose. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/.