caa a22 4500 60551030X CHVBK 20210128100645.0 cr unu---uuuuu 210128e20151001xx s 000 0 eng 10.1007/s10877-014-9634-y doi (NATIONALLICENCE)springer-10.1007/s10877-014-9634-y Pre-puncture ultrasound guided epidural insertion before vaginal delivery [Elektronische Daten] [Mahmoud Nassar, Ibrahim Abdelazim] 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. Springer Science+Business Media New York, 2014 Pre-puncture ultrasound nationallicence Combined spinal epidural nationallicence Vaginal delivery nationallicence Nassar Mahmoud Department of Anaesthesia, Alexandria University Hospital, Alexandria, Egypt aut Abdelazim Ibrahim Ahmadi Hospital, Kuwait Oil Company, Ahmadi, Kuwait aut Journal of Clinical Monitoring and Computing Springer Netherlands 29/5(2015-10-01), 573-577 1387-1307 29:5<573 2015 29 10877 https://doi.org/10.1007/s10877-014-9634-y text/html Onlinezugriff via DOI BK010053 XK010053 XK010000 Metadata rights reserved Springer special CC-BY-NC licence nationallicence 1 research-article jats NATIONALLICENCE NATIONALLICENCE NL-springer NATIONALLICENCE 856 40 https://doi.org/10.1007/s10877-014-9634-y text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Nassar Mahmoud Department of Anaesthesia, Alexandria University Hospital, Alexandria, Egypt aut NATIONALLICENCE 700 1- Abdelazim Ibrahim Ahmadi Hospital, Kuwait Oil Company, Ahmadi, Kuwait aut NATIONALLICENCE 773 0- Journal of Clinical Monitoring and Computing Springer Netherlands 29/5(2015-10-01), 573-577 1387-1307 29:5<573 2015 29 10877