title: Update for nurse anesthetists evidence-based anesthesia: The use of preprocedural ultrasonography during labor to facilitate placement of an epidural catheter.
abstract: Placement of an epidural catheter in parturients can be challenging because the anatomic changes of pregnancy may make it difficult to palpate an ideal insertion point or detect loss of resistance. Preprocedural ultrasonography (U/S-P) is reported to facilitate placement of epidural catheters in parturients. U/S-P provides information on the ideal insertion point, angle of needle insertion, and estimated depth to the epidural space. The purposes of this course are to describe the technique, systematically review the literature, and discuss techniques for integrating U/S-P into practice. It provides evidence demonstrating that U/S-P is a useful adjunct for placement of epidural catheters in obstetrical patients, especially patients with presumed "difficult backs" or obesity.
authors: Uniformed Services University of the Health Sciences, Nurse Anesthesia Program, Naval Medical Center San Diego, California, USA. crnaden@yahoo.com
authors: Dennis
authors: D
authors: Spence
authors: Ryan
authors: R
authors: Nations
authors: Orlando
authors: O
authors: Rivera
authors: Shawn
authors: S
authors: Bowdoin
authors: Bradley
authors: B
authors: Hazen
authors: Robert
authors: R
authors: Orgill
authors: John
authors: J
authors: Maye
mesh_terms: D000328:Adult; D016362:Analgesia, Obstetrical; D000767:Anesthesia, Epidural / Q000379:methods*; D000773:Anesthesia, Obstetrical / Q000379:methods*; D004496:Education, Continuing; D055317:Evidence-Based Practice / Q000379:methods; D005260:Female; D006801:Humans; D007743:Labor, Obstetric; D009719:Nurse Anesthetists; D011247:Pregnancy; D018084:Ultrasonography, Interventional / Q000379:methods*