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Peer-reviewedCC BY-NC-SASaudi journal of anaesthesia

Target-level epidural catheter placement in lower thoracic spine using preprocedural ultrasound marking: A prospective observational study.

  • Momoko Sasaki1
  • Yuya Murata1
  • Tetsuya Kodaira1
  • Mayuko Nonaka1
  • Kazushi Maruo2
  • Jungo Kato3
  1. 1Department of Anesthesiology, University of Tsukuba Hospital, Ibaraki, Japan.
  2. 2Department of Biostatistics, Institute of Medicine, University of Tsukuba, Ibaraki, Japan.
  3. 3Department of Anesthesiology, Institute of Medicine, University of Tsukuba, Ibaraki, Japan.
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Abstract

Background

Accurate insertion of catheters into the target intervertebral level is essential for effective epidural anesthesia. However, conventional palpation-based methods are often unreliable, resulting in unintended motor weakness of the lower limbs when insertion is performed at the lower thoracic level. In this study, we evaluated the accuracy of placing an epidural catheter at the target intervertebral level in the lower thoracic spine using preprocedural ultrasound marking.Methods

In this prospective observational study, we enrolled 40 adults undergoing elective surgery with planned lower thoracic epidural anesthesia. After identifying the spinal level using ultrasound and marking the spinous and transverse processes as landmarks, the epidural catheter was placed at the target level. Postoperative radiographs were used to confirm the actual placement level. Accuracy was assessed based on whether the level at which the epidural catheter was actually placed matched the target intervertebral level.Results

Of the 40 patients, data of 37 were included in the final analysis. The accuracy rate relative to the target intervertebral level was 89.2% (33/37; 95% confidence interval: 74.6-97.0%). No major misplacements (≧2 interspaces) were observed.Conclusion

In the lower thoracic spine, the use of preprocedural ultrasound marking enabled highly accurate placement of epidural catheters at the target intervertebral level.

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Cite

BibTeXRIS
BibTeX
@article{sasaki2026targetlevel,
  title = {{Target-level epidural catheter placement in lower thoracic spine using preprocedural ultrasound marking: A prospective observational study.}},
  author = {Momoko Sasaki and Yuya Murata and Tetsuya Kodaira and Mayuko Nonaka and Kazushi Maruo and Jungo Kato},
  journal = {Saudi journal of anaesthesia},
  year = {2026},
  month = oct,
  doi = {10.4103/sja.sja_422_26},
  url = {https://europepmc.org/article/MED/42960042},
  note = {CC BY-NC-SA},
}
RIS
TY  - JOUR
TI  - Target-level epidural catheter placement in lower thoracic spine using preprocedural ultrasound marking: A prospective observational study.
AU  - Momoko Sasaki
AU  - Yuya Murata
AU  - Tetsuya Kodaira
AU  - Mayuko Nonaka
AU  - Kazushi Maruo
AU  - Jungo Kato
PY  - 2026
DA  - 2026/10/01
JO  - Saudi journal of anaesthesia
DO  - 10.4103/sja.sja_422_26
UR  - https://europepmc.org/article/MED/42960042
AB  - Background  Accurate insertion of catheters into the target intervertebral level is essential for effective epidural anesthesia. However, conventional palpation-based methods are often unreliable, resulting in unintended motor weakness of the lower limbs when insertion is performed at the lower thoracic level. In this study, we evaluated the accuracy of placing an epidural catheter at the target intervertebral level in the lower thoracic spine using preprocedural ultrasound marking.Methods  In this prospective observational study, we enrolled 40 adults undergoing elective surgery with planned lower thoracic epidural anesthesia. After identifying the spinal level using ultrasound and marking the spinous and transverse processes as landmarks, the epidural catheter was placed at the target level. Postoperative radiographs were used to confirm the actual placement level. Accuracy was assessed based on whether the level at which the epidural catheter was actually placed matched the target intervertebral level.Results  Of the 40 patients, data of 37 were included in the final analysis. The accuracy rate relative to the target intervertebral level was 89.2% (33/37; 95% confidence interval: 74.6-97.0%). No major misplacements (≧2 interspaces) were observed.Conclusion  In the lower thoracic spine, the use of preprocedural ultrasound marking enabled highly accurate placement of epidural catheters at the target intervertebral level.
SN  - 1658-354X
SN  - 0975-3125
ER  -