Thoracic epidural puncture guided by an acoustic signal: clinical results

Lechner, Tobias; Wijk, M. G. F. van; Maas, Ad J.J.; Dorsten, F. R. C. van

doi:10.1017/s0265021504009056

Cited by 5 publications

(4 citation statements)

References 12 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…demonstrated the feasibility of this method in placement of thoracic as well as lumbar epidural catheters. [626364] Ghelber et al . [65] described a similar technique using a computer controlled injection pump to objectively measure the drop in pressure encountered on entering EDS.…”

Section: Discussionmentioning

confidence: 99%

Localization of epidural space: A review of available technologies

Elsharkawy

Sonny

Chin

2017

J Anaesthesiol Clin Pharmacol

View full text Add to dashboard Cite

Although epidural analgesia is widely used for pain relief, it is associated with a significant failure rate. Loss of resistance technique, tactile feedback from the needle, and surface landmarks are traditionally used to guide the epidural needle tip into the epidural space (EDS). The aim of this narrative review is to critically appraise new and emerging technologies for identification of EDS and their potential role in the future. The PubMed, Cochrane Central Register of Controlled Clinical Studies, and Web of Science databases were searched using predecided search strategies, yielding 1048 results. After careful review of abstracts and full texts, 42 articles were selected to be included. Newer techniques for localization of EDS can be broadly classified into techniques that (1) guide the needle to the EDS, (2) identify needle entry into the EDS, and (3) confirm catheter location in EDS. An ideal method should be easy to learn and perform, easily reproducible with high sensitivity and specificity, identifies inadvertent intrathecal and intravascular catheter placements with ease, feasible in perioperative setting and have a cost-benefit advantage. Though none of them in their current stages of development qualify as an ideal method, many show tremendous potential. Some techniques are useful in patients with difficult spinal anatomy and infants, and thus are complementary to traditional methods. In addition to improving the existing technology, future research should aim at proving the superiority of these techniques over traditional methods, specifically regarding successful EDS localization, better safety profile, and a favorable cost-benefit ratio.

show abstract

Section: Discussionmentioning

confidence: 99%

Localization of epidural space: A review of available technologies

Elsharkawy

Sonny

Chin

2017

J Anaesthesiol Clin Pharmacol

View full text Add to dashboard Cite

show abstract

“…The pressure information obtained on the tip of the needle is translated into an acoustic and visual signal. [ 14 15 ]…”

Section: Discussionmentioning

confidence: 99%

Acoustic puncture assist device™ versus conventional loss of resistance technique for thoracic paravertebral space identification: Clinical and ultrasound evaluation

Ali

Abdellatif

2017

Saudi J Anaesth

View full text Add to dashboard Cite

Background:Acoustic puncture assist device (APAD™) is a pressure measurement combined with a related acoustic signal that has been successfully used to facilitate epidural punctures. The principal of loss of resistance (LOR) is similar when performing paravertebral block (PVB). We investigated the usefulness of APAD™ by comparing it with the conventional LOR techniques for identifying paravertebral space (PVS).Subjects and Methods:A total of 100 women who were scheduled for elective breast surgery under general anesthesia with PVB were randomized into two equal groups. The first group (APAD group) was scheduled for PVB using APAD™. The second group (C group) was scheduled for PVB using conventional LOR technique. We recorded the success rate assessed by clinical and ultrasound findings, the time required to identify the PVS, the depth of the PVS and the number of attempts. The attending anesthesiologist was also questioned about the usefulness of the acoustic signal for detection of the PVS.Results:The incidence of successful PVB was (49) in APAD group compared to (42) in C group P < 0.05. The time required to do PVB was significantly shorter in APAD group than in C group (3.5 ± 1.35 vs. 4.1 ± 1.42) minutes. Two patients in APAD group needed two or more attempts compared to four patients in C group. The attending anesthesiologist found the acoustic signal valuable in all patients in APAD group.Conclusion:Using APAD™ compared to the conventional LOR technique showed a lower failure rate and a shorter time to identify the PVS.

show abstract

“…It has shown reliable results to detect epidural space in both lumbar and thoracic area. [5678] It provides an objective end point using both visual and auditory senses. Furthermore, it allows the usage of both hands for needle insertion.…”

Section: Introductionmentioning

confidence: 99%

Cervical epidural puncture guided by fluoroscopy in comparison to acoustic signals: Clinical results

2017

View full text Add to dashboard Cite

Background and Aim:The increasing cases of the cervical epidural but the practitioners in need for a new method to decrease the safety of the injection and to improve the learning curve of the trainee. Furthermore, it should replace the potentially hazards, conventional one, which is the fluoroscope. Acoustic signals were tested for this purpose.Methods:Thirty-two patients were assigned to have a cervical epidural for pain management using both acoustic signals and fluoroscopy simultaneously.Results:The incidence of success was 100% with no complications. Likewise, the decrease in fluoroscopy shots number was 70%.Conclusions:Acoustic signals are a simple, effective method of cervical epidural insertion. It reduces the usage of fluoroscopy and can be used as a learning tool.

show abstract

Thoracic epidural puncture guided by an acoustic signal: clinical results

Cited by 5 publications

References 12 publications

Localization of epidural space: A review of available technologies

Localization of epidural space: A review of available technologies

Acoustic puncture assist device™ versus conventional loss of resistance technique for thoracic paravertebral space identification: Clinical and ultrasound evaluation

Cervical epidural puncture guided by fluoroscopy in comparison to acoustic signals: Clinical results

Contact Info

Product

Resources

About