Central Neuraxial Blockade: Ultrasound
- DOI:
- 10.1093/med/9780199908004.003.0022
Successful central neuraxial blockade requires entry into the epidural or intrathecal space, and is contingent on the ability to guide a needle into the desired interlaminar space between adjacent vertebrae. Ultrasonography of the spine has been shown to be an effective tool for guiding epidural and spinal anesthesia. The use of ultrasound to central neuraxial blockade can broadly be divided into either preprocedural ultrasound imaging to delineate the underlying anatomy, or real-time ultrasound imaging of the needle as it is advanced toward the target. This chapter focuses only on preprocedural ultrasound imaging of the thoracic and lumbar spine, as real-time ultrasound-guided central neuraxial blockade is a challenging technique that requires much more investigation before it can be recommended for routine use. There is ample evidence to support the utility of ultrasound imaging of the spine in facilitating central neuraxial blockade. It is particularly useful in patients with challenging surface landmarks.
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