Table 1

Main characteristics of randomised controlled trials in this meta-analysis of ultrasound-guided lumbar puncture and epidural catheterisation

StudyYearCountryPatients (n)PopulationSettingProcedureEquipmentOperator experience
Grau25 2001Germany36/36Parturients with presumed difficult punctureLDECNANot reported
Grau26 2002Germany150/150Parturients scheduled for caesarean section or vaginal diliveryLDECSonoace 6000, 5.0 MHz curved array probe (Kretz, Marl, Germany)Not reported
Grau27 2004Germany20/10Obstetric patients scheduled for caesarean sectionLDCSELogiq 400, 7.5 MHz linear array probeNot reported
Pisupati34 2004USA14/19AdultsEDLPNot reportedNot reported
Nomura28 2007USA24/22AdultsEDLPSonoSite (Bothell, WA, USA), 5–10 MHz linear probePostgraduate year 2 residents who had fulfilled the ED
Lee29 2008Korea29/32AdultsEDLPSonosite MicroMaxx, 2–5 MHz curved probeNot reported
Cho30 2009Korea30/30Adults >60 years oldEDLPSonosite MicroMaxx, 2–5 MHz curved probeNot reported
Vallejo31 2010Canada189/181Laboring parturientsLDECThe Sonosite MicroMaxx ultrasound system (Sonosite), 2–5 MHz curved probeResidents had no more than five epidural placement attempts
Chin32 2011Canada60/60Adults with difficult surface anatomic landmarkORLPNAAnesthetists with more than 5 years of clinical experience in regional anaesthesia or consultant
Mofid33 2011Iran40/40AdultsEDLPNANot reported
Kawaguchi35 2011Japan12/12Adults scheduled scheduled to undergo total replacement of a hip jointORECLogiq Book XP with 3 C-RS 2–5 MHz convex probeNot reported
Wang41 2012China30/30Obese parturients scheduled for caesarean sectionLDCSE
  1. Turbo with a 5–10 MHz, convex probe, Sonosite

Anaesthetist with more than 10 years of experience in obstetric anaesthesia
Abdelhamid36 2013Egypt45/45AdultsA block roomLPSonosite S-Nerve
(Sonosite) ultrasound machine, a low-frequency (2–5 MHz)
Not reported
Sahin37 2013Germany50/50Parturients scheduled for caesarean sectionLDLPA Esaote Mylab 30 (Florence, Italy, convex transducer of 2–5 MHz)Operator who with extensive experience
Nassar44 2014Egypt55/55Parturients scheduled for vaginal diliveryLDCSE2–5 MHz, Sonosite MicroMaxx Ultrasound System English, USAOperator with more than 10 years of experience
Ansari12 2014United Arab Emirates75/75Obstetric patients scheduled for caesarean sectionLDLP(GE, Solingen, Germany), 4CRS 2–5.5 MHz broadband multifrequency probeAnesthetists with experience in ultra sound-guided neuraxial block (each had performed between 200 and 300 ultrasound-guided neuraxial blocks)
Peterson14 2014USA50/50AdultsEDLPAloka SSD 1400 US machin(Aloka, Wallingfod, CT), 3.5 MHz convex array or a 7.5 MHz linear array probeOperators performed at least 10 previous successful LPs by their
own report
Lim45 2014Singapore85/85AdultsORLP
  1. Turbo ultrasound machine (SonoSite, Fujifilm, Bothell, WA, USA), low frequency (2–5 MHz) curvilinear probe

Anaesthetists experienced in ultrasound-assisted neuraxial block
Mrcpi46 2015Ireland50/50Adults scheduled for elective total joint replacementsORLPUltrasound unit (SonixTablet, Peabody, MA) with a curved 2–5 MHz probeAnaesthesiologists had performed >75 neuraxial ultrasound scans before the study
Creaney11 2016Ireland10/10Obstetric patients scheduled for caesarean sectionLDLPSonosite NanoMaxx C60, 2–5 MHzAnaesthetists had completed 10 LPs with ultrasound guidance
Lahham13 2016USA71/87AdultsEDLPSonosite Fujifilm, 10–5 MHz linear array probeResident physician
Perna47 2017Italy30/28Obstetric patients scheduled for vaginal or caesarean diliveryLDECSonosite NanoMaxx, 5-2 MHz C60n Convex probeAnaesthetist with experience of more than 150 epidural procedures yearly
Elsharkawy43 2017USA14/18Adults with predicted difficult anatomyORLPGE Venue 40 (GE Healthcare, Waukesha, WI, USA) or Sonosite S-Nerve, low frequency (2–5 MHz) transducerAnaesthesiologists experienced with previously performed at
least 10 ultrasound-guided spinal anesthet ics prior to study initiation
Auyong38 2017USA33/37Adults undergoing any thoracicor upper abdominal surgeryORECNot reportedNot reported
Abraham39 2018Canada20/20AdultsOutpatient neuromuscular clinic.LPGeneral Electric LOGIQ S7 Expert, Toronto, Canada, 5 MHz (ML2-5)Not reported
Li42 2018China40/40Obese parturients scheduled for caesarean sectionLDLPM-Turbo ultrasound machine (GE, Solingen, Germany), a low-frequency (2–5 MHz) curvilinear probe.Three anaesthesiologists with 3 years of clinical expe rience in spinal anaesthesia
Ghisi16 2019Italy47/52Adults scheduled for lower limb surgeryORLPAccuro, Rivanna Medical, Praesidia Medical Devices, via dei Lapidari 19, Bologna, ItalyAnaesthesiologists skilled in both tech niques with a 25 or 27 G needle
Rizk17 2019USA120/60Adults scheduled for elective surgeryORLPThe Sonosite with a low frequency (2–5 MHz) curvilinear probeAnaesthesiologist trained and experienced in ultrasound-assisted neuraxial block.
  • CSE, combined spinal-epidural anaesthesia; ED, emergency department; EC, epidural catheterisation; LD, labour and delivery suite; LP, lumbar puncture; NA; OR, operating room.