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Automated ultrasound guidance streamlines epidural placement for challenging patients in labor


Unlike traditional ultrasound, the Accuro learning curve is minimal. Our physicians simply move the device along the patient’s back to identify the midline and interlaminar space. These landmarks appear as dotted red and orange overlays on the device. In addition, the estimated depths to the spinous process and the epidural space are displayed instantaneously on the Accuro screen. Users mark this location and then proceed with epidural placement. Accuro is so intuitive and friendly that it can be mastered by many within 10 minutes and operated with ease, even with only occasional use.

In addition to Labor and Delivery, a second Accuro device is in use at our hospital by the Acute Pain Service. The device has also been employed occasionally at our institution by pediatric oncologists who encountered difficult lumbar punctures.
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Before learning about the Accuro technology, I had been considering purchasing a more traditional ultrasound for Labor and Delivery. However, use of a traditional ultrasound machine would have been much more cumbersome, as well as being more difficult to use for those anesthesiologists who lacked ultrasound experience. Accuro’s sophisticated algorithms make image-guided epidural placement a reality for our anesthesia team at the University of Kentucky.

About the author: Dr. Regina Fragneto is professor of Anesthesiology and division chief, Obstetric Anesthesia at University of Kentucky College of Medicine.

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