RT Book, Section A1 Kwok, Wing Hong A1 Karmakar, Manoj A2 Hadzic, Admir SR Print(0) ID 55905019 T1 Chapter 44. Spinal Sonography and Considerations for Ultrasound-Guided Central Neuraxial Blockade T2 Hadzic's Peripheral Nerve Blocks and Anatomy for Ultrasound-Guided Regional Anesthesia, 2e YR 2012 FD 2012 PB The McGraw-Hill Companies PP New York, NY SN 978-0-07-154963-9 LK accessanesthesiology.mhmedical.com/content.aspx?aid=55905019 RD 2024/03/29 AB Ultrasound scanning (US) can offer several advantages when used to guide placement of the needle for centroneuraxial blocks (CNBs). It is noninvasive, safe, simple to use, can be performed expeditiously, provides real-time images, is devoid from adverse effects, and it may be beneficial in patients with abnormal or variant spinal anatomy. When used for chronic pain interventions, US also eliminates or reduces exposure to radiation. In expert hands, the use of US for epidural needle insertion was shown to reduce the number of puncture attempts,1–4 improve the success rate of epidural access on the first attempt,2 reduce the need to puncture multiple levels,2–4 and improve patient comfort during the procedure.3 These advantages led the National Institute of Clinical Excellence (NICE) in the United Kingdom to recommend the routine use of ultrasound for epidural blocks.5 Incorporating these recommendations into clinical practice, however, has met significant obstacles. As one example, a recent survey of anesthesiologists in the United Kingdom showed that >90% of respondents were not trained in the use of US to image the epidural space.6 In this chapter, we describe techniques of US imaging of the spine, the relevant sonoanatomy, and practical considerations for using US-guided CNB and nerve blocks close to the centroneuroaxis.