Pre-puncture ultrasound guided epidural insertion before vaginal delivery

Verfasser / Beitragende:
[Mahmoud Nassar, Ibrahim Abdelazim]
Ort, Verlag, Jahr:
2015
Enthalten in:
Journal of Clinical Monitoring and Computing, 29/5(2015-10-01), 573-577
Format:
Artikel (online)
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024 7 0 |a 10.1007/s10877-014-9634-y  |2 doi 
035 |a (NATIONALLICENCE)springer-10.1007/s10877-014-9634-y 
245 0 0 |a Pre-puncture ultrasound guided epidural insertion before vaginal delivery  |h [Elektronische Daten]  |c [Mahmoud Nassar, Ibrahim Abdelazim] 
520 3 |a Palpation method is widely used in clinical practice to identify the puncture site during combined spinal-epidural (CSE) blocks. Tuffier's line, is an anatomical landmark between two iliac crests (inter-cristal), which is widely used to identify the puncture site during CSE blocks is not always an indicator for specific vertebral level or inter-vertebral space. One hundred and Ten (110) women were scheduled for normal vaginal delivery and were randomized into two equal groups; palpation group and an ultrasound guided group to detect the efficacy of puncture ultrasound before CSE blocks to increase chances of successful CSE procedure on the first attempt and to reduce the number of attempts or punctures during insertion of CSE catheter. There were no significant differences between two studied groups regarding; maternal age, weight and height, while, there was a significant difference between two studied groups regarding; parity. Percentage of successful CSE procedure on the first attempt was significantly higher (67.27%) in ultrasound compared to palpation group (40%). Number of punctures (attempts) were significantly less in ultrasound (1.2±0.6) compared to palpation group (2.3±0.8) and the number of redirections was also significantly less in ultrasound (1.4±0.5) compared to palpation group (2.8±1.6). Although, time to identify puncture site was significantly longer in ultrasound compared to palpation group and total procedure time was longer in ultrasound (9.1±1.5min) compared to palpation group (6.2±1.2min), there was no significant difference between two studied groups regarding; time to identify puncture site and total procedure time. Two cases of dural puncture in palpation versus no cases in ultrasound group and two cases of intravascular catheter placement (one in each group), with no significant difference between two groups. Pre- puncture ultrasound guided epidural insertion before vaginal delivery, increases the chance of a successful CSE procedure on the first attempt and reduces the number of attempts during insertion of CSE catheter. 
540 |a Springer Science+Business Media New York, 2014 
690 7 |a Pre-puncture ultrasound  |2 nationallicence 
690 7 |a Combined spinal epidural  |2 nationallicence 
690 7 |a Vaginal delivery  |2 nationallicence 
700 1 |a Nassar  |D Mahmoud  |u Department of Anaesthesia, Alexandria University Hospital, Alexandria, Egypt  |4 aut 
700 1 |a Abdelazim  |D Ibrahim  |u Ahmadi Hospital, Kuwait Oil Company, Ahmadi, Kuwait  |4 aut 
773 0 |t Journal of Clinical Monitoring and Computing  |d Springer Netherlands  |g 29/5(2015-10-01), 573-577  |x 1387-1307  |q 29:5<573  |1 2015  |2 29  |o 10877 
856 4 0 |u https://doi.org/10.1007/s10877-014-9634-y  |q text/html  |z Onlinezugriff via DOI 
898 |a BK010053  |b XK010053  |c XK010000 
900 7 |a Metadata rights reserved  |b Springer special CC-BY-NC licence  |2 nationallicence 
908 |D 1  |a research-article  |2 jats 
949 |B NATIONALLICENCE  |F NATIONALLICENCE  |b NL-springer 
950 |B NATIONALLICENCE  |P 856  |E 40  |u https://doi.org/10.1007/s10877-014-9634-y  |q text/html  |z Onlinezugriff via DOI 
950 |B NATIONALLICENCE  |P 700  |E 1-  |a Nassar  |D Mahmoud  |u Department of Anaesthesia, Alexandria University Hospital, Alexandria, Egypt  |4 aut 
950 |B NATIONALLICENCE  |P 700  |E 1-  |a Abdelazim  |D Ibrahim  |u Ahmadi Hospital, Kuwait Oil Company, Ahmadi, Kuwait  |4 aut 
950 |B NATIONALLICENCE  |P 773  |E 0-  |t Journal of Clinical Monitoring and Computing  |d Springer Netherlands  |g 29/5(2015-10-01), 573-577  |x 1387-1307  |q 29:5<573  |1 2015  |2 29  |o 10877