Hesham Elsharkawy1 ,Rovnat Babazade2 , Sree Kolli3 , Hari Kalagara3 , and Mounir L. Soliman3 , 1 Departments of Anesthesia and Outcomes Research, CCLCM of Case Western Reserve University Cleveland Clinic, 2 Anesthesiology, Univeristy of Texas Medical Branch, Galveston, TX, and Outcomes Research Consortium, Cleveland, OH, 3 General Anesthesiology, Cleveland Clinic Cleveland, OH, USA
Korean Journal of Anesthesiology, 2016 August 69(4): 417-419
The authors describe the use of the Infiniti Plus (CIVCO Medical Solutions, Kalona, IA) needle guidance system in the facilitation of spinal anesthesia in patients with challenging anatomy such as scoliosis, obesity and advanced age. This publication presents two separate cases, using a S-Nerve (SonoSite, Bothell, WA) ultrasound system and a low frequency (2-5MHz) transducer (SonoSite, Bothell, WA) and the Infiniti Plus needle guide to successfully administer spinal anesthesia in patients with a history of difficult spinal anesthesia.
The authors demonstrate the use of ultrasound guidance has been used successfully for peripheral nerve blocks and spinal anesthesia. In this paper, the addition of the Infiniti Plus needle guidance system was used to assist physicians gain improved needle tip visualization during procedures where patients were historically difficult to scan. Improved visualization of the needle at depths greater than 4cm was observed.
In the first described case three attempts were unsuccessful without ultrasound needle guidance, and was then successful on the first attempt using ultrasound with the Infiniti Plus needle guidance system in a patient with a BMI of 30.4kg/m2.
In the second described case spinal anesthesia had been attempted on prior occasions that were unsuccessful and the patient experienced complications. Patient history included kyphoscoliosis and difficulty palpating normal anatomy. Using ultrasound and the Infiniti Plus needle guidance system spinal anesthesia was successful on the first attempt.
The authors conclude using CIVCO’s InfinIti Plus needle guidance system was instrumental in allowing: