A randomized comparison between Accuro and palpation-guided spinal anesthesia for obese patients undergoing orthopedic surgery

摘要: Background Although obese patients benefit from neuraxial anesthesia, technical difficulties often discourage its use. The current randomized trial compared Accuro, a hand-held, battery-operated ultrasound (US) device, and conventional palpation for spinal anesthesia in undergoing orthopedic surgery. We hypothesized that Accuro would decrease the number of needle redirections. Methods enrolled 130 men women with body mass index ≥30 kg/m2, scheduled lower limb surgery under block. Patients were either to Control group (group C: block after cutaneous landmarks) or A: preprocedural US scan identify insertion point). procedural time, skin passes redirections, occurrence failure adverse events recorded. Results Ninety-nine completed study. showed median (IQR) redirections 3 (0–9) through 1 (1-2) versus 6 (1-16) (1-3), respectively, (p=0.008, p=0.019). performance time was 558±232 s 348±255 (p Conclusions use reduced when performing but required longer time. Trial registration ClinicalTrials.gov registry (NCT03075488).