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Real‐time ultrasound‐guided spinal anesthesia in patients with a challenging spinal anatomy: two case reports
Author(s) -
CHIN K. J.,
CHAN V. W. S.,
RAMLOGAN R.,
PERLAS A.
Publication year - 2010
Publication title -
acta anaesthesiologica scandinavica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.738
H-Index - 107
eISSN - 1399-6576
pISSN - 0001-5172
DOI - 10.1111/j.1399-6576.2009.02112.x
Subject(s) - medicine , ultrasound , spinal anesthesia , lumbar , lumbar puncture , landmark , anatomical landmark , surgery , radiology , anesthesia , cerebrospinal fluid , pathology , artificial intelligence , computer science
Spinal anesthesia may be challenging in patients with poorly palpable surface landmarks or abnormal spinal anatomy. Pre‐procedural ultrasound imaging of the lumbar spine can help by providing additional anatomical information, thus permitting a more accurate estimation of the appropriate needle insertion site and trajectory. However, actual needle insertion in the pre‐puncture ultrasound‐ assisted technique remains a ‘blind’ procedure. We describe two patients with an abnormal spinal anatomy in whom ultrasound‐assisted spinal anesthesia was unsuccessful. Successful dural puncture was subsequently achieved using a technique of real‐time ultrasound‐ guided spinal anesthesia. This may be a useful option in patients in whom landmark‐guided and ultrasound‐assisted techniques have failed.