Ultrasonographic control of the puncture level for lumbar neuraxial block in obstetric anaesthesia

British Journal of Anaesthesia
H SchlotterbeckP Diemunsch

Abstract

Errors in the judgement of puncture level during neuraxial anaesthesia can lead to significant complications. The aim of this study was to assess, in obstetric anaesthesia, the accuracy of clinical determination of the lumbar spinal interspace level, using surface ultrasound imaging as control. At the anaesthesia follow-up visit, women who had received lumbar neuraxial anaesthesia during labour were prospectively included. The intervertebral level of needle insertion, located by the needle scar position, was identified by ultrasonography and compared with the clinical level reported on the chart by the anaesthetist who performed the block. Ninety-nine women were studied. The clinical puncture level was accurate in 36.4% of patients. Ultrasound examination showed the puncture level to be more cephalad than the level noted in the anaesthetic record in almost 50% of patients. In 15% of patients, the puncture level was more caudad than the anaesthetist had assessed. Factors including type of anaesthesia, indication, time period, level of anaesthetic experience, BMI, and spinal pathology did not seem to influence the frequency of errors. The observed differences between clinical and ultrasonic identification of spinal puncture level...Continue Reading

Associated Clinical Trials

Sep 18, 2015·Georgios KotsovolisGeorgios Kotsovolis

Citations

Feb 3, 2009·Annales Françaises D'anesthèsie Et De Rèanimation·L DelaunayD Jochum
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May 7, 2009·Current Opinion in Anaesthesiology

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