Ultrasound-based Accuro system versus traditional palpation technique for neuraxial anaesthesia: A systematic review and meta-analysis of randomised controlled trials.
| Autor: | Sharapi M; Our Lady of Lourdes Hospital, Drogheda, Ireland., Afifi E; Faculty of Medicine, Benha University, Benha, Egypt., Al Mawla AM; Jordan University of Science and Technology, Irbid, Jordan., Yassin MNA; Faculty of Medicine, Helwan University, Helwan, Egypt., Awwad SA; Jordan University of Science and Technology, Irbid, Jordan., El-Samahy M; Faculty of Human Medicine, Zagazig University, Zagazig, Egypt. |
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| Jazyk: | angličtina |
| Zdroj: | Journal of perioperative practice [J Perioper Pract] 2023 Dec 27, pp. 17504589231215927. Date of Electronic Publication: 2023 Dec 27. |
| DOI: | 10.1177/17504589231215927 |
| Abstrakt: | Introduction: This review evaluates the efficacy and safety of Accuro, a handheld ultrasound device, compared to the palpation technique for neuraxial anaesthesia. Accuro provides real-time imaging guidance, potentially improving accuracy and efficiency. Methods: A comprehensive search across six electronic databases identified randomised clinical trials comparing Accuro with palpation for neuraxial anaesthesia. Risk ratios or mean differences with 95% confidence intervals (CIs) were calculated using a random-effects model. Bias risk was evaluated using the Cochrane Risk of Bias tool. Results: Five studies (n=369) met the inclusion criteria. Accuro showed a favourable risk ratio for first insertion success (1.44 [95% CI [1.01, 2.05], p=0.05]). It significantly reduced needle skin passes (MD -0.63; 95% CI [-1.05, -0.21]; p<0.01), but not needle redirection (MD -1.31; 95% CI [-2.71, 0.11]; p=0.07). Procedure time was shorter in palpation (MD 127.82; 95% CI [8.68, -246.97]; p=0.04). Four studies had a low risk of bias; one had some concerns. Conclusion: Accuro can potentially improve success rates and reduce skin passes in neuraxial anaesthesia. Further trials with larger samples are needed, especially in patients with anticipated difficulties. Competing Interests: Declaration of conflicting interestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship and/or publication of this article. |
| Databáze: | MEDLINE |
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