Accuro ultrasound-based system with computer-aided image interpretation compared to traditional palpation technique for neuraxial anesthesia placement in obese parturients undergoing cesarean delivery: a randomized controlled trial
Purpose Recently, a new handheld ultrasound-based device, called Accuro, has been commercialized with a real-time automated interpretation of lumbar ultrasound images. We hypothesized that the handheld ultrasound device would improve the efficacy and safety of combined spinal-epidural anesthesia (CS...
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| Veröffentlicht in: | Journal of anesthesia 2021-08, Vol.35 (4), p.475-482 |
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| container_title | Journal of anesthesia |
| container_volume | 35 |
| creator | Ni, Xiu Li, Meng-zhu Zhou, Shuang-qiong Xu, Zhen-dong Zhang, Yue-qi Yu, Yi-bing Su, Jing Zhang, Li-min Liu, Zhi-qiang |
| description | Purpose
Recently, a new handheld ultrasound-based device, called Accuro, has been commercialized with a real-time automated interpretation of lumbar ultrasound images. We hypothesized that the handheld ultrasound device would improve the efficacy and safety of combined spinal-epidural anesthesia (CSEA) for cesarean delivery in obese parturients.
Methods
Eighty parturients with a body mass index > 30 kg∙m
−2
scheduled for elective cesarean delivery were randomly allocated equally (palpation group and ultrasound group). The primary outcome was the first insertion success rate. Secondary outcomes were the time taken to identify the needle puncture site, duration of CSEA procedure, the total time, the rate of parturients who require needle redirections, the number of skin punctures, changes in the intended interspace, and the incidence of complications.
Results
Compared to the palpation group, the first insertion success rate was significantly higher (72.5% vs. 40.0%;
P
= 0.003), and time taken to identify the needle puncture site was less (30 [26–36] vs. 39 [32–49] seconds;
P
= 0.001) in the ultrasound group. The rate of parturients who required needle redirections (40.0% vs. 72.5%;
P
= 0.003) and the incidence of paresthesia were both lower (7.5% vs. 45.0%;
P
|
| doi_str_mv | 10.1007/s00540-021-02922-y |
| format | Article |
| fullrecord | <record><control><sourceid>gale_proqu</sourceid><recordid>TN_cdi_proquest_miscellaneous_2534610543</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><galeid>A669481891</galeid><sourcerecordid>A669481891</sourcerecordid><originalsourceid>FETCH-LOGICAL-c453t-3aaed51b13170625b721b062e2a39fda54b3de549e672b0309546b02a933d52c3</originalsourceid><addsrcrecordid>eNp9kt2q1DAQx4souK6-gFcBb7zpMWnabuvdcvALDnij12GaTLs5pElNUnV9YV_D2VNvhEVCSJj8_vORmaJ4KfiN4PzwJnHe1LzklaDdV1V5flTsRC27spNN_7jY8V7Ismvb7mnxLKV7znkrhNwVv49arzGw1eUIKazelAMkNCydU8aZ_bD5xHSYlzVjLMEaerIzTMisJ8sSMUO2wT8wEOk1B0aujL1YwbEF3LIRGfXJ228rsjFE5nGN8NMSAR5TPmGywBYHGmf0mbyzMGBC0se8Rku2xCg7jFOwfmIaE0UDzww6-x3j-S0DFsGbMNtflIUOPsfg3CWhSFGeF09GcAlf_D33xdf3777cfizvPn_4dHu8K3XdyFxKADSNGIQUB95WzXCoxEAXrED2o4GmHqTBpu6xPVQDl7xv6nbgFfRSmqbScl-83vwuMVCpKavZJo3OUZVhTapqZN0KapYk9NWGTuBQWT8G-jd9wdWxbfu6Ex01bV-UV6gJPUZwweNoyfwPf3OFp2VwtvqqoNoEOoaUIo5qidTheFaCq8twqW24FA2XehgudSaR3ESJYD9hVPdhjdTv9D_VHzZM2TA</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2534610543</pqid></control><display><type>article</type><title>Accuro ultrasound-based system with computer-aided image interpretation compared to traditional palpation technique for neuraxial anesthesia placement in obese parturients undergoing cesarean delivery: a randomized controlled trial</title><source>SpringerLink Journals - AutoHoldings</source><creator>Ni, Xiu ; Li, Meng-zhu ; Zhou, Shuang-qiong ; Xu, Zhen-dong ; Zhang, Yue-qi ; Yu, Yi-bing ; Su, Jing ; Zhang, Li-min ; Liu, Zhi-qiang</creator><creatorcontrib>Ni, Xiu ; Li, Meng-zhu ; Zhou, Shuang-qiong ; Xu, Zhen-dong ; Zhang, Yue-qi ; Yu, Yi-bing ; Su, Jing ; Zhang, Li-min ; Liu, Zhi-qiang</creatorcontrib><description>Purpose
Recently, a new handheld ultrasound-based device, called Accuro, has been commercialized with a real-time automated interpretation of lumbar ultrasound images. We hypothesized that the handheld ultrasound device would improve the efficacy and safety of combined spinal-epidural anesthesia (CSEA) for cesarean delivery in obese parturients.
Methods
Eighty parturients with a body mass index > 30 kg∙m
−2
scheduled for elective cesarean delivery were randomly allocated equally (palpation group and ultrasound group). The primary outcome was the first insertion success rate. Secondary outcomes were the time taken to identify the needle puncture site, duration of CSEA procedure, the total time, the rate of parturients who require needle redirections, the number of skin punctures, changes in the intended interspace, and the incidence of complications.
Results
Compared to the palpation group, the first insertion success rate was significantly higher (72.5% vs. 40.0%;
P
= 0.003), and time taken to identify the needle puncture site was less (30 [26–36] vs. 39 [32–49] seconds;
P
= 0.001) in the ultrasound group. The rate of parturients who required needle redirections (40.0% vs. 72.5%;
P
= 0.003) and the incidence of paresthesia were both lower (7.5% vs. 45.0%;
P
< 0.001). The other outcomes had no significant difference between groups. The mean difference between the epidural depth measured by the handheld ultrasound and needle depth was − 0.29 cm [95% limit of agreement, − 0.52 to − 0.05].
Conclusions
Our study suggests using the Accuro ultrasound device can enhance the efficacy and safety of CSEA in obese parturients when executed by experienced anesthesiologists, and its automated estimation of epidural depth is accurate.</description><identifier>ISSN: 0913-8668</identifier><identifier>EISSN: 1438-8359</identifier><identifier>DOI: 10.1007/s00540-021-02922-y</identifier><language>eng</language><publisher>Singapore: Springer Singapore</publisher><subject>Anesthesia ; Anesthesiology ; Body mass index ; Cesarean section ; Comparative analysis ; Critical Care Medicine ; Emergency Medicine ; Intensive ; Medicine ; Medicine & Public Health ; Methods ; Original Article ; Pain Medicine</subject><ispartof>Journal of anesthesia, 2021-08, Vol.35 (4), p.475-482</ispartof><rights>Japanese Society of Anesthesiologists 2021. corrected publication 2021</rights><rights>COPYRIGHT 2021 Springer</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c453t-3aaed51b13170625b721b062e2a39fda54b3de549e672b0309546b02a933d52c3</citedby><cites>FETCH-LOGICAL-c453t-3aaed51b13170625b721b062e2a39fda54b3de549e672b0309546b02a933d52c3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s00540-021-02922-y$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s00540-021-02922-y$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,780,784,27922,27923,41486,42555,51317</link.rule.ids></links><search><creatorcontrib>Ni, Xiu</creatorcontrib><creatorcontrib>Li, Meng-zhu</creatorcontrib><creatorcontrib>Zhou, Shuang-qiong</creatorcontrib><creatorcontrib>Xu, Zhen-dong</creatorcontrib><creatorcontrib>Zhang, Yue-qi</creatorcontrib><creatorcontrib>Yu, Yi-bing</creatorcontrib><creatorcontrib>Su, Jing</creatorcontrib><creatorcontrib>Zhang, Li-min</creatorcontrib><creatorcontrib>Liu, Zhi-qiang</creatorcontrib><title>Accuro ultrasound-based system with computer-aided image interpretation compared to traditional palpation technique for neuraxial anesthesia placement in obese parturients undergoing cesarean delivery: a randomized controlled trial</title><title>Journal of anesthesia</title><addtitle>J Anesth</addtitle><description>Purpose
Recently, a new handheld ultrasound-based device, called Accuro, has been commercialized with a real-time automated interpretation of lumbar ultrasound images. We hypothesized that the handheld ultrasound device would improve the efficacy and safety of combined spinal-epidural anesthesia (CSEA) for cesarean delivery in obese parturients.
Methods
Eighty parturients with a body mass index > 30 kg∙m
−2
scheduled for elective cesarean delivery were randomly allocated equally (palpation group and ultrasound group). The primary outcome was the first insertion success rate. Secondary outcomes were the time taken to identify the needle puncture site, duration of CSEA procedure, the total time, the rate of parturients who require needle redirections, the number of skin punctures, changes in the intended interspace, and the incidence of complications.
Results
Compared to the palpation group, the first insertion success rate was significantly higher (72.5% vs. 40.0%;
P
= 0.003), and time taken to identify the needle puncture site was less (30 [26–36] vs. 39 [32–49] seconds;
P
= 0.001) in the ultrasound group. The rate of parturients who required needle redirections (40.0% vs. 72.5%;
P
= 0.003) and the incidence of paresthesia were both lower (7.5% vs. 45.0%;
P
< 0.001). The other outcomes had no significant difference between groups. The mean difference between the epidural depth measured by the handheld ultrasound and needle depth was − 0.29 cm [95% limit of agreement, − 0.52 to − 0.05].
Conclusions
Our study suggests using the Accuro ultrasound device can enhance the efficacy and safety of CSEA in obese parturients when executed by experienced anesthesiologists, and its automated estimation of epidural depth is accurate.</description><subject>Anesthesia</subject><subject>Anesthesiology</subject><subject>Body mass index</subject><subject>Cesarean section</subject><subject>Comparative analysis</subject><subject>Critical Care Medicine</subject><subject>Emergency Medicine</subject><subject>Intensive</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Methods</subject><subject>Original Article</subject><subject>Pain Medicine</subject><issn>0913-8668</issn><issn>1438-8359</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2021</creationdate><recordtype>article</recordtype><recordid>eNp9kt2q1DAQx4souK6-gFcBb7zpMWnabuvdcvALDnij12GaTLs5pElNUnV9YV_D2VNvhEVCSJj8_vORmaJ4KfiN4PzwJnHe1LzklaDdV1V5flTsRC27spNN_7jY8V7Ismvb7mnxLKV7znkrhNwVv49arzGw1eUIKazelAMkNCydU8aZ_bD5xHSYlzVjLMEaerIzTMisJ8sSMUO2wT8wEOk1B0aujL1YwbEF3LIRGfXJ228rsjFE5nGN8NMSAR5TPmGywBYHGmf0mbyzMGBC0se8Rku2xCg7jFOwfmIaE0UDzww6-x3j-S0DFsGbMNtflIUOPsfg3CWhSFGeF09GcAlf_D33xdf3777cfizvPn_4dHu8K3XdyFxKADSNGIQUB95WzXCoxEAXrED2o4GmHqTBpu6xPVQDl7xv6nbgFfRSmqbScl-83vwuMVCpKavZJo3OUZVhTapqZN0KapYk9NWGTuBQWT8G-jd9wdWxbfu6Ex01bV-UV6gJPUZwweNoyfwPf3OFp2VwtvqqoNoEOoaUIo5qidTheFaCq8twqW24FA2XehgudSaR3ESJYD9hVPdhjdTv9D_VHzZM2TA</recordid><startdate>20210801</startdate><enddate>20210801</enddate><creator>Ni, Xiu</creator><creator>Li, Meng-zhu</creator><creator>Zhou, Shuang-qiong</creator><creator>Xu, Zhen-dong</creator><creator>Zhang, Yue-qi</creator><creator>Yu, Yi-bing</creator><creator>Su, Jing</creator><creator>Zhang, Li-min</creator><creator>Liu, Zhi-qiang</creator><general>Springer Singapore</general><general>Springer</general><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20210801</creationdate><title>Accuro ultrasound-based system with computer-aided image interpretation compared to traditional palpation technique for neuraxial anesthesia placement in obese parturients undergoing cesarean delivery: a randomized controlled trial</title><author>Ni, Xiu ; Li, Meng-zhu ; Zhou, Shuang-qiong ; Xu, Zhen-dong ; Zhang, Yue-qi ; Yu, Yi-bing ; Su, Jing ; Zhang, Li-min ; Liu, Zhi-qiang</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c453t-3aaed51b13170625b721b062e2a39fda54b3de549e672b0309546b02a933d52c3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2021</creationdate><topic>Anesthesia</topic><topic>Anesthesiology</topic><topic>Body mass index</topic><topic>Cesarean section</topic><topic>Comparative analysis</topic><topic>Critical Care Medicine</topic><topic>Emergency Medicine</topic><topic>Intensive</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Methods</topic><topic>Original Article</topic><topic>Pain Medicine</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Ni, Xiu</creatorcontrib><creatorcontrib>Li, Meng-zhu</creatorcontrib><creatorcontrib>Zhou, Shuang-qiong</creatorcontrib><creatorcontrib>Xu, Zhen-dong</creatorcontrib><creatorcontrib>Zhang, Yue-qi</creatorcontrib><creatorcontrib>Yu, Yi-bing</creatorcontrib><creatorcontrib>Su, Jing</creatorcontrib><creatorcontrib>Zhang, Li-min</creatorcontrib><creatorcontrib>Liu, Zhi-qiang</creatorcontrib><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of anesthesia</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Ni, Xiu</au><au>Li, Meng-zhu</au><au>Zhou, Shuang-qiong</au><au>Xu, Zhen-dong</au><au>Zhang, Yue-qi</au><au>Yu, Yi-bing</au><au>Su, Jing</au><au>Zhang, Li-min</au><au>Liu, Zhi-qiang</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Accuro ultrasound-based system with computer-aided image interpretation compared to traditional palpation technique for neuraxial anesthesia placement in obese parturients undergoing cesarean delivery: a randomized controlled trial</atitle><jtitle>Journal of anesthesia</jtitle><stitle>J Anesth</stitle><date>2021-08-01</date><risdate>2021</risdate><volume>35</volume><issue>4</issue><spage>475</spage><epage>482</epage><pages>475-482</pages><issn>0913-8668</issn><eissn>1438-8359</eissn><abstract>Purpose
Recently, a new handheld ultrasound-based device, called Accuro, has been commercialized with a real-time automated interpretation of lumbar ultrasound images. We hypothesized that the handheld ultrasound device would improve the efficacy and safety of combined spinal-epidural anesthesia (CSEA) for cesarean delivery in obese parturients.
Methods
Eighty parturients with a body mass index > 30 kg∙m
−2
scheduled for elective cesarean delivery were randomly allocated equally (palpation group and ultrasound group). The primary outcome was the first insertion success rate. Secondary outcomes were the time taken to identify the needle puncture site, duration of CSEA procedure, the total time, the rate of parturients who require needle redirections, the number of skin punctures, changes in the intended interspace, and the incidence of complications.
Results
Compared to the palpation group, the first insertion success rate was significantly higher (72.5% vs. 40.0%;
P
= 0.003), and time taken to identify the needle puncture site was less (30 [26–36] vs. 39 [32–49] seconds;
P
= 0.001) in the ultrasound group. The rate of parturients who required needle redirections (40.0% vs. 72.5%;
P
= 0.003) and the incidence of paresthesia were both lower (7.5% vs. 45.0%;
P
< 0.001). The other outcomes had no significant difference between groups. The mean difference between the epidural depth measured by the handheld ultrasound and needle depth was − 0.29 cm [95% limit of agreement, − 0.52 to − 0.05].
Conclusions
Our study suggests using the Accuro ultrasound device can enhance the efficacy and safety of CSEA in obese parturients when executed by experienced anesthesiologists, and its automated estimation of epidural depth is accurate.</abstract><cop>Singapore</cop><pub>Springer Singapore</pub><doi>10.1007/s00540-021-02922-y</doi><tpages>8</tpages></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 0913-8668 |
| ispartof | Journal of anesthesia, 2021-08, Vol.35 (4), p.475-482 |
| issn | 0913-8668 1438-8359 |
| language | eng |
| recordid | cdi_proquest_miscellaneous_2534610543 |
| source | SpringerLink Journals - AutoHoldings |
| subjects | Anesthesia Anesthesiology Body mass index Cesarean section Comparative analysis Critical Care Medicine Emergency Medicine Intensive Medicine Medicine & Public Health Methods Original Article Pain Medicine |
| title | Accuro ultrasound-based system with computer-aided image interpretation compared to traditional palpation technique for neuraxial anesthesia placement in obese parturients undergoing cesarean delivery: a randomized controlled trial |
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