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Abstract
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Background and Aims The technique for spinal anesthesia placement in infants has not changed for over 130 years. The standard approach is a landmark-based technique using palpation of the vertebral interspaces and blind advancement of the needle into the intrathecal space. However, with the advancements in ultrasound technology, there may be an opportunity to use direct imaging to improve the success rate of this procedure in infants. Our primary objective was to conduct a retrospective analysis of our spinal anesthesia practices at Boston Children’s Hospital in infants
Methods This was a retrospective observational study. Data was obtained from the electronic anesthesia record. The comparison of ultrasound-guided and landmark-based approaches for spinal anesthesia was performed using the non-parametric Wilcoxon rank sum test for continuous outcomes and Fisher’s exact test for categorical measures. A two-tailed p<0.05 was used to determine statistical significance.
Results 197 spinals were performed mostly for inguinal hernia repairs. We encountered a tendency of the ultrasound-guided technique to provide a higher overall success rate and first-pass success rate than the traditional landmark-based technique when performing an infant spinal. No major complications were observed.
Ultrasound images for US-guided spinal anesthesia placement
Conclusions Live in-plane ultrasound guidance can improve the first-pass and overall success rate of spinal anesthesia in infants.