title: The use of ultrasound improves the accuracy of epidural needle placement in cadavers.
abstract: OBJECTIVE
  To investigate whether epidural-prepuncture ultrasound imaging improves the accuracy and quality of epidural needle placement or not?
  
  
  METHODS
  By recruiting 15 cadavers, a total of 90 epidural needle punctures to access epidural space in study group with the help of ultrasound imaging at lumbar and thoracic spinal segments were attempted. A similar number of punctures in a control group were also performed without ultrasound imaging involving the intervertebral spaces adjacent to the ones used for ultrasound guided punctures. The accuracy of needle tip placement was ascertained with the help of computed axial tomography. Six variables: puncture depth and needle angle, procedure time, number of attempts per space, steps in needle advances, number of bony contacts and number of spaces attempted, were studied and compared among the groups.
  
  
  RESULTS
  The accuracy of epidural needle placement and quality of the procedure in study group were superior to the control group.
  
  
  CONCLUSIONS
  The pre-procedure ultrasound imaging enhances the accuracy and quality of epidural needle placement.
authors.affiliation: Department of Anaesthesiology, University Hospital Heidelberg, Im Neuenheimer Feld 110, 69120, Heidelberg, Germany, jens.kessler@med.uni-heidelberg.de.
authors.forename: Jens
authors.initials: J
authors.lastname: Kessler
authors.forename: Bernhard
authors.initials: B
authors.lastname: Moriggl
authors.forename: Thomas
authors.initials: T
authors.lastname: Grau
mesh_terms: D000369:Aged, 80 and over; D000767:Anesthesia, Epidural / Q000295:instrumentation*; D002102:Cadaver; D005260:Female; D006801:Humans; D008297:Male; D009339:Needles; D011677:Punctures; D018084:Ultrasonography, Interventional / Q000379:methods*