Ultrasound-guided Lumbar Central Neuraxial Anesthesia

Banchobporn Songthamwat

Authors

Banchobporn Songthamwat Chulalongkorn Hospital

Keywords:

neuraxial anesthesia, spinal, epidural, ultrasound

Abstract

Central neuraxial anesthesia is usually performed
using palpation of surface anatomical landmark at lumbar
region. However, this technique is difficult in some patient
especially those who are obese, pregnant, having previous
spinal surgery or abnormal spinal anatomy. Multiple
attempts at needle placement can increase the incidence
of complications including post dural puncture headache
(PDPH), spinal hematoma, neural injury and patient
discomfort during the procedure. In recent years,
ultrasound has been used to facilitate the neuraxial
anesthesia as a tool to overcome the shortcomings of
conventional approach. Neuraxial ultrasound scans
provide precise identification of vertebral levels and
underlying anatomy as well as prediction the depth of
intrathecal or epidural space. Therefore, it can reduce the
number of puncture attempts and improve success rate
of neuraxial anesthesia.

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