Ultrasound Guidance Significantly Lowers Risk for Failed Lumbar Punctures and Epidural Catheterizations

Lumbar puncture (LP) is performed for diagnostic purposes (e.g., analysis of cerebrospinal fluid [CSF]) and for drug delivery, and epidural catheterization is performed to administer anesthetics. But sometimes these procedures fail. In this meta-analysis of 17 randomized, controlled trials involving 1300 patients, investigators determined whether ultrasound (US)-guided imaging, compared with standard palpation of anatomical landmarks, can lower risk for failed LPs or epidural catheterizations.

Five studies evaluated LP and nine evaluated epidural catheterization. Failed LP was defined as lack of CSF return; failed epidural catheterization was defined as inability to place an epidural catheter, need for intraoperative analgesia, or need to re…