Notice bibliographique
Résumé
<h3>Goals:</h3> To summarize the existing evidence behind the role of ultrasonography in neuraxial anesthesia techniques. <h3>Methods:</h3> A literature search of the MEDLINE, PubMed, ACP Journal Club databases, and the <i>Cochrane Database of Systematic Reviews</i> was performed using the term ultrasonography combined with each of the following: spinal, intrathecal, epidural, and lumbar puncture. Only studies related to regional anesthesia or acute pain practice were included. Case reports and letters to the editor were excluded. Seventeen relevant studies were identified and included in this review. <h3>Results:</h3> Neuraxial ultrasonography is a recent development in regional anesthesia practice. Most clinical studies to date come from a limited number of centers and have been performed by very few and highly experienced operators. The existing evidence may be classified in 2 main content areas: (<i>a</i>) ultrasound-assisted neuraxial techniques and (<i>b</i>) real-time ultrasound-guided neuraxial techniques. <i>(a) Ultrasound-assisted neuraxial techniques</i>: Two scanning planes have been identified to offer useful acoustic windows for the assessment of spinal sonoanatomy providing complementary information: A parasagittal scanning plane (paramedian, longitudinal window) and an axial plane (transverse midline window). A preprocedure ultrasound can more accurately determine the location of a specific vertebral interspace than physical examination alone. The epidural and intrathecal spaces may be identified by ultrasonography, and the skin-to-epidural space or skin-to-intrathecal space distances may be accurately predicted. The use of a preprocedure ultrasound is associated with a lower number of attempts and a lower number of interspaces attempted by experienced anesthesiologists inserting an epidural catheter for labor analgesia. It may improve learning curves of junior trainees. <i>(b) Real-time ultrasound-guided neuraxial techniques</i>: Fewer and more recent studies report the use of this modality, mostly in the pediatric population. When performed by experienced anesthesiologists on selected patients with otherwise normal anatomy, the resulting efficacy is similar to that of standard techniques, but it may result in a shorter procedure time and less instances of "bony contact." A paucity of data exists in the nonobstetric adult population and on the impact of ultrasound use on safety profile. <h3>Conclusions:</h3> Neuraxial ultrasonography has been recently introduced to regional anesthesia practice. The limited data available to date suggest that it is a useful adjunct to physical examination, allowing for a highly precise identification of regional landmarks and a precise estimation of epidural space depth, thus facilitating epidural catheter insertion. Further research is needed to conclusively establish its impact on procedure success and safety profile, particularly in the adult nonobstetric population.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction distillée sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Apprise à partir de 10 348 étiquettes directes de Codex et de 10 348 étiquettes directes de Gemma. Le mode candidate est l'union des têtes enseignantes seuillées; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont ni des étiquettes humaines ni des étiquettes directes de modèles de pointe.
Scores Codex et Gemma par catégorie
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,005 | 0,002 |
| Méta-épidémiologie (sens strict) | 0,001 | 0,000 |
| Méta-épidémiologie (sens large) | 0,002 | 0,001 |
| Bibliométrie | 0,000 | 0,001 |
| Études des sciences et des technologies | 0,000 | 0,001 |
| Communication savante | 0,000 | 0,000 |
| Science ouverte | 0,001 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,001 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,000 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule tête enseignante, pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».