Clinical Value

Improve the safety, speed, and efficiency of epidural and spinal anesthesia.

Because Accuro automatically identifies epidural location with success rates exceeding 94%*, Accuro gives you confidence when performing epidurals or spinals, even in the most challenging patients.

Reduce risk of complications and placement failures

Save time and money

Improve patient satisfaction

The value of Accuro

Accuro’s automated 3D spinal navigation technology is clinically proven to increase first-attempt success rates, reduce needle passes, reduce placement times, and significantly increase patient satisfaction with pain control. Collectively, these benefits significantly reduce the cost of care.
RIVANNA can provide a customized analysis of how the Accuro adds value to any healthcare system – small or large. To request a detailed and customized value analysis, please contact us on our contact page.

Clinically Proven Benefits

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.

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)

PUBLICATIONS

Clinical publications

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 SpineNav3DTM 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: http://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.

** Figures are estimates of cost savings only and are based on several sources. Cost model for complications based on Macario et al, Anesthesiology. 2000. Complication rate and time reductions based on results from clinical trial NCT0244297.