Department of Anesthesiology, Alexandra General Hospital, Athens, Greece.
Minerva Anestesiol. 2011 Feb;77(2):154-9. Epub 2010 Nov 24.
The purpose of this study was to measure the skin to epidural space distance (SED), the skin to subarachnoid space distance (SSD) and the epidural to subarachnoid space distance (ESD) at the L3-4 interspace in parturients scheduled for caesarean section (CS) and to investigate whether any correlations exist between these distances and various physical and anthropometric parameters.
This study consisted of 332 parturients scheduled for CS. The epidural space was identified by noting the loss of resistance to air at the L3-4 intervertebral space with a Tuohy needle, thus permitting measurement of the SED. The spinal needle was introduced through the Tuohy needle and, after identification of the subarachnoid space, was locked in the epidural needle. The distance between the tip of the Tuohy needle and tip of spinal needle (ESD) was recorded. This number was added to the SED to obtain the SSD value.
Mean values ± standard deviations for SED, SSD and ESD were 5.6 ± 1.6 cm, 6.5 ± 1.2 cm and 0.9 ± 0.5 cm, respectively. Statistically significant correlations were observed between SED, SSD and ESD with body mass index and body weight of the parturients, as well as between the SED and the parturient's height. Furthermore, a significant negative correlation was observed between the ESD and gestational age. Finally, a significant correlation existed between the SSD and ESD.
Measurements of SED, SSD and ESD in parturients and the correlations between these distances to various physical and anthropometric parameters may be of potential value for combined spinal-epidural anesthesia (CSEA) in parturients scheduled for CS.
本研究旨在测量行剖宫产术产妇的 L3-4 椎间的皮至硬膜外腔距离（SED）、皮至蛛网膜下腔距离（SSD）和硬膜外腔至蛛网膜下腔距离（ESD），并探讨这些距离与各种体格和人体测量参数之间是否存在相关性。
本研究纳入了 332 例行剖宫产术的产妇。硬膜外腔通过在 L3-4 椎间使用 Tuohy 针注气时出现阻力消失来确定，从而可以测量 SED。将脊髓针通过 Tuohy 针插入，在确认蛛网膜下腔后，将其锁定在硬膜外针内。记录 Tuohy 针尖端到脊髓针尖端的距离（ESD）。将这个数字加上 SED 就可以得到 SSD 值。
SED、SSD 和 ESD 的平均值±标准差分别为 5.6±1.6cm、6.5±1.2cm 和 0.9±0.5cm。SED、SSD 和 ESD 与产妇的体重指数和体重、SED 与产妇的身高均呈显著相关，此外，ESD 与孕龄呈显著负相关，SSD 和 ESD 之间存在显著相关性。
在计划行剖宫产术的产妇中测量 SED、SSD 和 ESD 以及这些距离与各种体格和人体测量参数之间的相关性，可能对产妇的联合脊髓-硬膜外麻醉（CSEA）具有潜在价值。
