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It reduces the usage of fluoroscopy and can be used as a learning tool.Keywords: Acoustic signals; cervical epidural; fluoroscopy How to cite this URL: Ali H M, Toble Y, Tolba Y.This site stores nothing other than an automatically generated session ID in the cookie; no other information is captured.In general, only the information that you provide, or the choices you make while visiting a web site, can be stored in a cookie.Exclusion criteria All patients with coagulopathy, allergy to any of the used medications, septic focus, refusal, neuromuscular disease, or previous cervical spine surgery that may disturb the anatomy or patient refusal.An intravenous access was inserted, and vital signs were monitored (noninvasive blood pressure, oxygen saturation, and electrocardiograph).Cervical epidural puncture guided by fluoroscopy in comparison to acoustic signals: Clinical results.

The pressure inside the needle and the APAD tube was related only to tissue resistance as the saline infusion in the needle was constant (100 ml/h), as the needle was advanced.

The pain physician was standing behind the patient after complete cleaning and aseptic precautions.

The procedure was performed by an expert pain physician. 1 - Patient monitor, 2 - acoustic puncture assist device monitor, 3 - acoustic puncture assist device connections and needle, 4 - pain physician, 5 - fluoroscopy screen, 6 - C-arm tube, 7 - patient in sitting position, 8 - C-arm tube The APAD system was connected as shown in [Figure 3] with a 120 cm tube connected to the needle from one side and to the transducer on the other side, then another tube from the transducer to the syringe pump which was loaded with 20 ml syringe filled with saline and adjusted to rate of 100 ml/h.

Furthermore, it should replace the potentially hazards, conventional one, which is the fluoroscope. Methods: Thirty-two patients were assigned to have a cervical epidural for pain management using both acoustic signals and fluoroscopy simultaneously.

Results: The incidence of success was 100% with no complications.

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