<b>Introduction:</b> Ultrasound facilitates neuraxial puncture in obese parturients. Unfortunately, the widespread adoption of neuraxial ultrasound may be limited by the lack of technical expertise or the ...<b>Introduction:</b> Ultrasound facilitates neuraxial puncture in obese parturients. Unfortunately, the widespread adoption of neuraxial ultrasound may be limited by the lack of technical expertise or the limited availability of the equipment. A wireless portable ultrasound device (Accuro, Rivanna Medical, Charlottesville, VA) with automated pattern recognition software (SpineNav3DTM technology) has been introduced to obtain the automated real-time identification of interspaces and epidural depth. The primary objective of this study was to assess the accuracy of the SpineNav3DTM ultrasound technology (Accuro) in estimating the epidural space depth compared to the standard ultrasound examination in pregnant obese patients. The secondary aim was to compare the ultrasound measurements with the measured needle depth during epidural and spinal insertion. <b>Methods:</b> The study was conducted at S Gerardo Hospital, Monza, Italy from March 2021 to April 2021. Obese laboring women requesting epidural analgesia or undergoing elective cesarean delivery under spinal anesthesia were recruited. All the subjects had their lumbar area scanned for the measurements of the depth of the epidural space by the SpineNav3DTM ultrasound technology and by the standard US and then both compared with the needle insertion depth in a double-blind fashion. <b>Results:</b> Forty-eight women were enrolled in the study. There was agreement (±0.25 cm) between the epidural depth (in cm) measured with the Accuro, versus the standard ultrasound. There was a significant difference between the mean depth of epidural space s measured by Accuro or Standard US and needle insertion depth (P < 0.001). <b>Conclusions:</b> The handheld ultrasound system with 3D spine navigation technology can automatically identify and measure the epidural depth with the same accuracy as the standard ultrasounds in obese pregnant women.展开更多
Background: The SpineNav3DTM technology was recently incorporated in the Accuro device for the automatic detection of spinal bone landmarks. The goal of our study was to validate the ability of the Accuro ultrasound s...Background: The SpineNav3DTM technology was recently incorporated in the Accuro device for the automatic detection of spinal bone landmarks. The goal of our study was to validate the ability of the Accuro ultrasound scanner to detect the distance from skin to epidural space by comparing it to the golden standard (the standard ultrasound). The secondary end-point was the inter-rater agreement between an expert anesthesiologist and a novice trainee in determining the epidural space depth with the Accuro device. Methods: 96 consecutive healthy volunteer parturients at term had their lumbar area scanned for the measurements of the depth of the epidural space (recorded in cm) by two anesthesiologists. The expert investigator made the measurements with both the standard ultrasound and the Accuro devices, and the trainee made the measurements with the Accuro device only. Results: There were no differences in the mean depth of the epidural space as measured by the expert or the novice investigator with both the devices (standard ultrasound and Accuro) in both positions (sitting and lateral) at any intervertebral level with a difference less than 0.25 cm. Conclusion: We have demonstrated that this handheld ultrasound system with 3D spine navigation technology can automatically identify the key neuraxial landmarks within ultrasound images of the lumbar spine acquired in the transverse plane and measure the epidural depth with the same accuracy as the standard ultrasounds. We have also demonstrated that the measurements may be rapidly and adequately obtained by a novice who had never previously used ultrasounds.展开更多
文摘<b>Introduction:</b> Ultrasound facilitates neuraxial puncture in obese parturients. Unfortunately, the widespread adoption of neuraxial ultrasound may be limited by the lack of technical expertise or the limited availability of the equipment. A wireless portable ultrasound device (Accuro, Rivanna Medical, Charlottesville, VA) with automated pattern recognition software (SpineNav3DTM technology) has been introduced to obtain the automated real-time identification of interspaces and epidural depth. The primary objective of this study was to assess the accuracy of the SpineNav3DTM ultrasound technology (Accuro) in estimating the epidural space depth compared to the standard ultrasound examination in pregnant obese patients. The secondary aim was to compare the ultrasound measurements with the measured needle depth during epidural and spinal insertion. <b>Methods:</b> The study was conducted at S Gerardo Hospital, Monza, Italy from March 2021 to April 2021. Obese laboring women requesting epidural analgesia or undergoing elective cesarean delivery under spinal anesthesia were recruited. All the subjects had their lumbar area scanned for the measurements of the depth of the epidural space by the SpineNav3DTM ultrasound technology and by the standard US and then both compared with the needle insertion depth in a double-blind fashion. <b>Results:</b> Forty-eight women were enrolled in the study. There was agreement (±0.25 cm) between the epidural depth (in cm) measured with the Accuro, versus the standard ultrasound. There was a significant difference between the mean depth of epidural space s measured by Accuro or Standard US and needle insertion depth (P < 0.001). <b>Conclusions:</b> The handheld ultrasound system with 3D spine navigation technology can automatically identify and measure the epidural depth with the same accuracy as the standard ultrasounds in obese pregnant women.
文摘Background: The SpineNav3DTM technology was recently incorporated in the Accuro device for the automatic detection of spinal bone landmarks. The goal of our study was to validate the ability of the Accuro ultrasound scanner to detect the distance from skin to epidural space by comparing it to the golden standard (the standard ultrasound). The secondary end-point was the inter-rater agreement between an expert anesthesiologist and a novice trainee in determining the epidural space depth with the Accuro device. Methods: 96 consecutive healthy volunteer parturients at term had their lumbar area scanned for the measurements of the depth of the epidural space (recorded in cm) by two anesthesiologists. The expert investigator made the measurements with both the standard ultrasound and the Accuro devices, and the trainee made the measurements with the Accuro device only. Results: There were no differences in the mean depth of the epidural space as measured by the expert or the novice investigator with both the devices (standard ultrasound and Accuro) in both positions (sitting and lateral) at any intervertebral level with a difference less than 0.25 cm. Conclusion: We have demonstrated that this handheld ultrasound system with 3D spine navigation technology can automatically identify the key neuraxial landmarks within ultrasound images of the lumbar spine acquired in the transverse plane and measure the epidural depth with the same accuracy as the standard ultrasounds. We have also demonstrated that the measurements may be rapidly and adequately obtained by a novice who had never previously used ultrasounds.
