Accuro is a Clinically Proven Solution for Neuraxial Anesthesia Guidance.
Improve the safety, speed, and efficiency of epidural and spinal anesthesia with Accuro, which automates the identification of the patient’s spinal midline and interlaminar space with success rates exceeding 94%.
81% higher first-insertion success rates
81% fewer needle redirections
83% fewer paresthesia instances (even for experienced providers)
90% reduction in patients who reported patient satisfaction of less than 4 on a 5-point scale.
Contact us for a personalized analysis of how Accuro will add value to your healthcare system.
Performance claims: M. Tiouririne et al.; D. Ghisi et al.; Ni, X., Li, Mz., Zhou, Sq. et al.; Singla et al.
Clinically Proven Benefits
First-attempt success improvement with minimal prior Accuro training
D. Ghisi et al., “A randomized comparison between Accuro and palpation-guided spinal anesthesia for obese patients undergoing orthopedic surgery.” Reg Anesth Pain Med. 2019 Oct; 2019-100538.
Singla et al., “Feasibility of spinal anesthesia placement using automated interpretation of lumbar ultrasound images: a prospective randomized controlled trial.” J Anesth Clin Res. 2019; 10: 878.
Accuro enhances the efficacy of spinal anesthesia placement compared to traditional palpation
Ni, X., Li, Mz., Zhou, Sq. et al., “Accuro ultrasound-based system with computer-aided image interpretation compared to traditional palpation technique for neuraxial anesthesia placement in obese parturients undergoing cesarean delivery: a randomized controlled trial.” J Anesth (2021).
D. Ghisi et al., “A randomized comparison between Accuro and palpation-guided spinal anesthesia for obese patients undergoing orthopedic surgery.” Reg Anesth Pain Med. 2019 Oct; 2019-100538.
Singla et al., “Feasibility of spinal anesthesia placement using automated interpretation of lumbar ultrasound images: a prospective randomized controlled trial.” J Anesth Clin Res. 2019; 10: 878.
Over 50% fewer patients reporting dissatisfaction with pain control
Singla et al., “Feasibility of spinal anesthesia placement using automated interpretation of lumbar ultrasound images: a prospective randomized controlled trial.” J Anesth Clin Res. 2019; 10: 878.
Reduction in needle placement time for spinal anesthesia
Singla et al., “Feasibility of spinal anesthesia placement using automated interpretation of lumbar ultrasound images: a prospective randomized controlled trial.” J Anesth Clin Res. 2019; 10: 878.
Accurate identification of the desired interlaminar space with 94% success
M. Tiouririne, et al, “Imaging performance of a handheld ultrasound system with real-time computer-aided detection of lumbar spine anatomy: a feasibility study.”
K. Seligman, et al., “The Accuracy of a Handheld Ultrasound Device for Neuraxial Depth and Landmark Assessment: A Prospective Cohort Trial.” Anesthesia & Analgesia. 2018; 126(6): 1995-1998.
Accuro SpineNav3D is accurate to within 3 mm of manual measurements by expert radiologists or ultrasound users
Ultrasound improves success of spinal anesthesia, reduces number of needle sticks, improves safety
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 Pain Med. 2016 Mar-Apr;41(2):251-60.
- Note: Estimated 79% reduction in risk of failed lumbar puncture or epidural catheterization from multiple studies (Perlas et al 2016)
- Note: Estimated 73% reduction in risk of traumatic procedure from multiple studies (Perlas et al 2016)
B. Young et al., Conventional landmark palpation vs. preprocedural ultrasound for neuraxial analgesia and anaesthesia in obstetrics – a systematic review and meta-analysis with trial sequential analyses. Anaesthesia. (2021).
Publications
Clinical publications
Kimizuka M., et al., “Usefulness and accuracy of a handheld ultrasound device for epidural landmark and depth assessment by anesthesiology residents.” J Anesth. 2022 Dec;36(6):693-697. doi: 10.1007/s00540-022-03096-x. Epub 2022 Aug 27. PMID: 36029336.
S. Baglioni, et al., “Accuracy of the SpineNav3D™ Ultrasound Technology in Estimating the Epidural Space Depth for Epidural and Spinal Insertion in Pregnant Obese Patients.” Open Journal of Anesthesiology. Vol. 11 No. 8, pp. 221-228, 2021.
Ni, X., Li, Mz., Zhou, Sq., et al., “Accuro ultrasound-based system with computer-aided image interpretation compared to traditional palpation technique for neuraxial anesthesia placement in obese parturients undergoing cesarean delivery: a randomized controlled trial.” J Anesth. 2021.
D. Ghisi, et al., “A randomized comparison between Accuro and palpation-guided spinal anesthesia for obese patients undergoing orthopedic surgery.” Reg Anesth Pain Med. 2019 Oct; 2019-100538.
Singla, et al., “Feasibility of spinal anesthesia placement using automated interpretation of lumbar ultrasound images: a prospective randomized controlled trial.” J Anesth Clin Res. 2019; 10: 878.
B. Carvalho, et al., “The comparative accuracy of a handheld and console ultrasound device for neuraxial depth and landmark assessment.” Int J Obstet Anesth. 2019 Aug; 39:68-73.
G. Capogna, et al. “Accuracy of the SpineNav3D™ Technology to Measure the Depth of Epidural Space: A Comparison with the Standard Ultrasound Technique in Pregnant Volunteers” Open Journal of Anesthesiology, 2018; 8(4): 113-122.
K. Seligman, et al., “The Accuracy of a Handheld Ultrasound Device for Neuraxial Depth and Landmark Assessment: A Prospective Cohort Trial.” Anesthesia & Analgesia. 2018; 126(6): 1995-1998.
J. Ramteke, et al., “New technology: Handheld ultrasound-assisted localization of epidural space.” Saudi J Anaesth [serial online] 2018 [cited 2018 Mar 16];12:365-7. Available from: https://www.saudija.org/text.asp?2018/12/2/365/227022
M. Tiouririne, et al., “Imaging performance of a handheld ultrasound system with real-time computer-aided detection of lumbar spine anatomy: a feasibility study.” Investigative Radiology. 2017; 52(8): 447-455.
Technology publications
M. Tiouririne, et al., Handheld real-time volumetric imaging of the spine: technology development. Journal of Medical Engineering & Technology. Vol. 38(2), pp. 100-103, 2014.
K. Owen, et al., Improved elevational and azimuthal motion tracking using sector scans. IEEE Transactions on Ultrasonics, Ferroelectrics, and Frequency Control. Vol. 60, No. 4, pp. 671 – 684, 2013.
F. W. Mauldin, Jr., et al., The effects of transducer geometry on artifacts common to diagnostic bone imaging with conventional medical ultrasound. IEEE Transactions on Ultrasonics, Ferroelectrics, and Frequency Controls. Vol. 59, no. 6, pp. 1101-1114, 2012. PMID: 22711406
F. W. Mauldin, Jr., et al., Mitigation of off-axis specular reflection artifacts in diagnostic bone imaging with medical ultrasound using mechanically scanned piston transducers. 2011 IEEE Ultrasonics Symposium, Orlando, FL, pp. 385-388, 2011.
K. Owen, et al., Transducer motion estimation using combined ultrasound signal decorrelation and optical sensor data for low-cost ultrasound systems with increased field of view. 2011 IEEE Ultrasonics Symposium, Orlando, FL, pp. 1431-1434, 2011.
F. W. Mauldin, Jr., et al., Three-dimensional spinal bone imaging with medical ultrasound for epidural anesthesia guidance. 2011 IEEE Ultrasonics Symposium, Orlando, FL. pp. 238-241, 2011.
Clinical presentations
J. Pan, et al., “Evaluation of Success in Spinal Block Placement Between Using Palpation of Landmark versus Pocket-size Handheld Ultrasound (U/S) Method in Cesarean Delivery Anesthesia” Anesthesiology, San Francisco, CA, October 2018.
M. Kimizuka, et al., “Effectiveness of Accuro (a handheld ultrasound device for epidural anesthesia)” Anesthesiology, San Francisco, CA, October 2018.
P. Pinedo, et al., “Epidural blood patch and identification of the epidural space – Is there room for improvement?” Euroanaesthesia 2018: The European Anaesthesiology Congress, 35(56), June 2018, pp. 103-104.
J. Caicedo, et al., “Comparison between novel 2D-3D ultrasound system with pattern recognition and a conventional 2D ultrasound system for assessment of the lumbar spine: a cohort study in volunteers” SOAP 50th Annual Meeting, Miami, May 2018.
J. Chadha, et al., “Evaluation of success in neuraxial block placement between using palpation of landmark versus pocket-size handheld ultrasound (U/S) method” SOAP 50th Annual Meeting, Miami, May 2018.
D. Van Hecke, et al., “An original miniature automated ultrasound-based system for spinal anesthesia against usual sonography: preliminary case-series” Euroanaesthesia 2017: The European Anaesthesiology Congress, 34(55), June 2017, pp. 95-96.
L. Powlovich et al., “Does automated interpretation of lumbar spine ultrasound images increase success rate of spinal anesthesia placement for cesarean birth among residents in training?” SOAP 49th Annual Meeting, Bellevue, May 2017.
R. Shankar et al., “New Technology for an Old Problem: Ultrasound-Assisted Spinal Anesthesia in a Parturient with History of Scoliosis Spine Surgery.” SOAP 49th Annual Meeting, Bellevue, May 2017.
K.Seligman, et al., “Accuracy of a Handheld Ultrasound Device and a Traditional Ultrasound for Neuraxial Depth and Landmark Assessment in Cohort Receiving Labor Epidurals.” SOAP 49th Annual Meeting, Bellevue, May 2017.
K.Seligman, et al., “Accuracy of a Handheld Ultrasound Device and a Traditional Ultrasound for Neuraxial Depth and Landmark Assessment.” 42nd Annual Regional Anesthesiology and Acute Pain Medicine Meeting, San Francisco, April 2017
Brendan Carvalho, “Neuraxial Ultrasound: Time to Learn and Not Get Left Behind.” SOAP SOL Shnider, San Francisco, March 2017
M. Tiouririne et al., “Dedicated handheld ultrasound system for spinal and epidural placement.” Anesthesiology. San Diego, CA, October 2015.
M. Tiouririne, et al., “Evaluation of handheld ultrasound imaging system for ultrasound-assisted epidural and spinal placement.” European Society of Regional Anesthesia. Ljubljana, Slovenia, September 2015.
A. Sardesai., “Advances in ultrasound machine technology & future trends.” AORA 2015. Bengaluru, India, September 2015.
* M. Tiouririne, et al., “Imaging performance of a handheld ultrasound system with real-time computer-aided detection of lumbar spine anatomy: a feasibility study.” Investigative Radiology. 2017; 52(8): 1-8. Study was performed in the lumbar spine region for both obese and normal BMI subjects.
** Complication rate and time reductions are representative figures based on studies referenced on this page, such as Singla, et al., 2019.
Practice guidelines
National Institute for Health and Care Excellence. (2021). Medtech innovation briefing [MIB245]: Accuro for spinal or epidural anesthesia administration in people with obesity. London, UK: NICE.
Soni, N. J., et al., (2019). Recommendations on the Use of Ultrasound Guidance for Adult Lumbar Puncture: A Position Statement of the Society of Hospital Medicine. Journal of Hospital Medicine, 14(10), 591-601. doi: 10.12788/jhm.3197. Epub 2019 Jun 10.
AANA Board of Directors. (2017). Analgesia and anesthesia for the obstetric patient: Practice guidelines.