The Evidence
Performance Inspired. Automatically identify epidural location “with one hand tied behind your back.”
Because Accuro is better than 94%* successful in automatically identifying epidural location, Accuro replaces the guesswork that comes with “blind-needle guidance” with confidence when you’re performing epidurals or spinals.
THE EVIDENCE
Over a decade of clinical data and more than thirty peer-reviewed publications show that ultrasound technology can help you more accurately identify a given lumbar intervertebral space when administering an epidural or spinal anesthesia.
Research shows that ultrasound reduces the number of needle sticks and improves efficacy and safety. That’s good news for your practice and especially comforting news for your patients.
The following publications prove the efficacy of Accuro’s ultrasound-guided spinal anesthesia in terms of detecting epidural location and depth, reducing the number of needle sticks, and improving patient safety:
CLINICALLY PROVEN BENEFITS
Halpern S, et al. The use of ultrasound for lumbar spinous process identification: a pilot study. Can J Anaesth. 57:817-22, 2010.
Lee A, et al. Ultrasound assessment of the vertebral level of the intercristal line in pregnancy. Anesth Analg. 113:559-564, 2011.
Locks G, et al. Use of the ultrasound to determine the level of lumbar puncture in pregnant women. Rev Bras Anestesiol. 60:13-10, 2010.
Schlotterbeck H, et al. Ultrasonographic control of the puncture level for lumbar neuraxial block in obstetric anesthesia. Br J Anesth. 100:230-234, 2008.
Watson M, et al. Could ultrasonography be used by an anaesthetist to identify a specified lumbar interspace before spinal anaesthesia? Br J Anaesth. 90:509-511, 2003.
Whitty R, et al. Identification of the lumbar interspinous spaces: palpation versus ultrasound. Anesth Analg. 106:538-540, 2008.
Duniec L, et al. Anatomical landmarks based assessment of intravertebral space level for lumbar puncture is misleading in more than 30%. Anaesthesiol Intensive Ther. 45: 1-6, 2013.
Balki M, et al. Ultrasound imaging of the lumbar spine in the transverse plane: the correlation between estimated and actual depth to the epidural space in obese parturients. Anesth Analg. 108: 1876-1881, 2009.
Chin K, et al. An ultrasound-assisted approach facilitates spinal anesthesia for total joint arthroplasty. Can J Anesth. 56:643-650, 2009.
Cork R, et al. Ultrasonic localization of the lumbar epidural space. Anesthesiology. 52: 513-516, 1980.
Currie J. Measurement of the depth to the extradural space using ultrasound. Br J Anaesth. 56:345-347, 1984.
Ferre R and Weeney T. Emergency physicians can easily obtain ultrasound images of anatomical landmarks relevant to lumbar puncture. Am J Emerg Med. 25:291-296, 2007.
Gnaho A, et al. Assessing the depth of the subarachnoid space by ultrasound. Rev Bras Anestesiol. 2:520-530, 2012.
Grau T, et al. Ultrasound control for presumed difficult epidural puncture. Acta Anaesthesiol Scand. 45:766-771, 2001.
Grau T, et al. Ultrasound imaging facilitates localization of the epidural space during combined spinal and epidural anesthesia. Reg Anesth Pain Med. 26:64-67, 2001.
Grau T, et al. Efficacy of ultrasound imaging in obstetric epidural anesthesia. J Clin Anesth. 14:169-175, 2002.
Helayel P, et al. Evaluating the depth of the epidural space with the use of ultrasound. 60:376-382, 2010.
Tran D, et al. Preinsertion paramedian ultrasound guidance for epidural anesthesia. Anesth Analg. 109:661-667, 2009.
Vallejo M, et al. Ultrasound decreases the failed labor epidural rate in resident trainees. Int J Obstet Anesth. 19:373-378, 2010.
Grau T, et al. Ultrasound imaging facilitates localization of the epidural space during combined spinal and epidural anesthesia. Reg Anesth Pain Med. 26:64-67, 2001.
Grau T, et al. Efficacy of ultrasound imaging in obstetric epidural anesthesia. J Clin Anesth. 14:169-175, 2002.
Vallejo M, et al. Ultrasound decreases the failed labor epidural rate in resident trainees. Int J Obstet Anesth. 19:373-378, 2010.
Chin K, et al. Ultrasound imaging facilitates spinal anesthesia in adults with difficult surface anatomic landmarks. Anesthesiology. 115:94-101, 2011.
Grau T, et al. Real-time ultrasonic observation of combined spinal-epidural anaesthesia. Eur J Anaesthesiol. 21:25-31, 2004.
Nomura J, et al. A randomized controlled trial of ultrasound-assisted lumbar puncture. J Ultrasound Med. 26:1341-1348, 2007.
Wang Q, et al. Ultrasound facilitates identification of combined spinal-epidural puncture in obese parturients. Chin Med J (Engl). 125:3840-3843, 2012.
Ansari T, et al. Ultrasound-guided spinal anesthesia in obstetrics: is there an advantage over the landmark technique in patients with easily palpable spines? Int J Obstet Anesth. 23:213-216, 2014.
Lim Y, et al. A randomized controlled trial of ultrasound-assisted spinal anesthesia. Anaesth Intensive Care. 42:191-198, 2014.
Mofidi M, et al. Ultrasound guided lumbar puncture in emergency department: time saving and less complications. J Res Med Sci. 18:303-307, 2013.
Sahin T, et al. A randomized controlled trial of preinsertion ultrasound guidance for spinal anesthesia in pregnancy: outcomes among obese and lean parturients: ultrasound for spinal anesthesia in pregnancy. J Anesth. 28:413-419, 2014.
Perlas A, et al. Lumbar neuraxial ultrasound for spinal and epidural anesthesia: a systematic review and meta-analysis. Reg Anesth and Pain Med. 40, 2015.
Note: Estimated 79% reduction in risk of failed lumbar puncture or epidural catheterization from multiple studies (estimated by Perlas et al 2015)
Note: Estimated 73% reduction in risk of traumatic procedure from multiple studies (estimated by Perlas et al 2015)