Obstetric Anaesthesia Annual Scientific Meeting 2023

Ultrasound guided neuraxial anaesthesia: improving the anaesthetists’ confidence in scanning the lumbar spine
Urvi Sanganee (trainee), Lucy Foote (trainee), Eoin Harty (consultant), Northwick Park Hospital, LNWH Trust London

Introduction

•Central neuraxial blockade (CNB) is traditionally performed using a landmark technique. This can be difficult in some patients, resulting in multiple attempts, failure, or risk of complications such as dural puncture.

•In 2008, NICE1 recommended the routine use of ultrasound (US) for epidural insertion. A pre-puncture scan is used to locate midline, the level of the intervertebral space, and the depth of the epidural space1.

•RCTs have shown a significant decrease in puncture attempts for pregnant women underdoing epidurals using a pre-procedure scan compared to no scan at all.2,3

•US guided CNB is uncommon in our department – when surveyed, anaesthetists cited lack of experience and lack of training as primary barriers.

Obstetric Anaesthesia Annual Scientific Meeting 2023

Ultrasound guided neuraxial anaesthesia: a quality improvement project to improve anaesthetist competence and confidence scanning the lumbar spine

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