Accuro Neuraxial Anesthesia Guidance

Anesthesiologists and CRNAs: Choose Accuro Neuraxial Guidance for automated landmark identification. Experience faster, safer, and easier epidurals, and take control of positive patient outcomes.

Accuro: Clinically Proven Neuraxial Guidance


HIGHER first-insertion success rates


FEWER paresthesia instances (even for experienced providers)


REDUCTION in patients who reported patient satisfaction of less than 4 on a 5-point scale.

Ultrasound Simplified: Pinpoint key neuraxial targets, including the interlaminar space and depth, using Accuro’s AI-enabled image guidance and unique bone-imaging technology. Clinically proven to improve first-attempt success rates, especially in patients with complex anatomy, Accuro’s effectiveness surpasses traditional ‘blind’ palpation methods, regardless of provider experience, the type of neuraxial anesthesia, or previous Accuro training.

Enhance Patient Safety and Clinical Efficiency

More than 3.5 million neuraxial anesthesia procedures are performed annually in the U.S., primarily in the labor and delivery department. With needle placement failure rates ranging from 20% to 80% — largely based on clinician skill, patient BMI, and age — complications such as repeated attempts, long-term pain, and even paralysis in rare yet devastating cases are significant concerns.



reported first-attempt failure rates using palpation in obese patients.



higher first-attempt success rates reported with pre-procedural ultrasound.



competence levels reported for interspace identification with ultrasound.



increase in first-attempt success rates reported with Accuro.

About Us

Founded in 2010 by University of Virginia graduate students, our co-founder was driven by a compelling problem statement: to dramatically reduce the high failure rates of epidural and spinal anesthesia placements with optimized ultrasound technology. This enduring commitment to addressing unexplored healthcare challenges has propelled RIVANNA to become a leader in medical imaging technology, continuously innovating to meet unmet clinical needs and improve healthcare delivery.

56 Global Patents & Patents Pending

$59M DHHS Awards to Date

200+ Hospitals

5 Continents

Real-World Accuro Success Stories

“Accuro is a game changer… I use it now in all my procedures and to train our residents. Not only are we improving our first-attempt success rates with Accuro, but we are also noticing a reduction in back pain and wet taps. By improving efficiency and reducing risk, we are greatly improving the standard of care we provide to our patients.”

Antonio Gonzalez, M.D.

Assistant Professor of Anesthesiology, Yale School of Medicine

“A morbidly obese patient had two difficult epidural placements by other anesthesia providers. Both epidurals failed after six hours… I utilized the Accuro device and placed a working CSE within five minutes…Both the surgeon and patient were pleased. It was a fabulous example of the need for the device.”

Beth Ann Clayton

DNP, MS, CRNA, Associate Professor of Clinical Nursing University of Cincinnati

RIVANNA’s Role in Modern Healthcare

Bridging Gaps

Our proprietary technology solutions address unmet clinical needs across a wide array of clinical indications within government, industry, and clinical settings to provide simple, cost-effective alternatives to the existing standard of care.

Elevating Standards

Our advantage stems from integrating bone-specific ultrasound technology with AI-enabled software. This combination delivers a comprehensive imaging-based solution that improves patient safety through radiation-free alternatives and increases provider precision and efficiency with integrated clinician support.

Effective Change

Collaboration is vital in the healthcare marketplace to develop solutions that advance our healthcare landscape. RIVANNA’s participation in conferences and contributions to medical literature drive meaningful engagement and transformative change for our partners in the field.

Get the Accuro advantage.

Recent Insights

How Accuro Supports CRNA Education

How Accuro Supports CRNA Education

Nurse anesthesia education requires precision, hands-on practice, and the ability to navigate complex anatomical structures. Beth Clayton — seasoned Professor and Program Director at the University of Cincinnati — emphasizes the critical role of effective teaching...

Accuro’s Impact in Labor and Delivery

Accuro’s Impact in Labor and Delivery

Anesthesiologist Dr. Stephen Garber describes Accuro’s ultrasound guidance for neuraxial anesthesia as an indispensable tool in his practice. Learn how this AI-powered device helps anesthesiologists personalize care, enhancing confidence and procedural precision for...

Performance claims: A. Macario et al. (2000); M. Tiouririne et al. (2017); Singla et al. (2019); D. Ghisi et al. (2019); Ni, X., Li, Mz., Zhou, Sq. et al.