Efficacy of pre-procedural ultrasound in facilitating neuraxial anesthetics: An integrative review

Abstract

<p>The purpose of this integrative review is to investigate the efficacy of pre-procedural ultrasound examination to facilitate neuraxial anesthesia techniques and its impact on first attempt success rates, number of attempts required, and duration of procedure. A literature review was performed to obtain current research involving the use of ultrasound for neuraxial anesthesia. Fourteen randomized-control trials (RCT) met criteria and were included in this review. Six RCTs demonstrate significant increases in first attempt success rates and four RCTs suggest no significant difference in the first attempt success rate when ultrasound is utilized for neuraxial anesthesia techniques. Ten of the RCTs&nbsp;suggest that the use of pre-procedural ultrasound examination significantly reduces the number of attempts required for neuraxial anesthesia techniques while three found no significant difference. Four out of five RCTs found a significant increase in total duration of the procedure when pre-procedural ultrasound examination was utilized.&nbsp;The most striking benefit of pre-procedural ultrasound examination is the reduction in number of attempts required for successful neuraxial anesthetics. Pre-procedural ultrasound is particularly beneficial in the obese patient population in whom landmarks are difficult to palpate.</p>