Kosturakis Alyssa, Soliz Jose, Su Jackson, Cata Juan P, Feng Lei, Harun Nusrat, Amsbaugh Ashley, Gebhardt Rodolfo
University of Texas San Antonio Health Science Center, San Antonio, TX 78249, USA.
Department of Anesthesiology and Perioperative Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA.
Pain Res Treat. 2015;2015:470240. doi: 10.1155/2015/470240. Epub 2015 Apr 16.
Background and Objectives. Previous studies have used varying methods to estimate the depth of the epidural space prior to placement of an epidural catheter. We aim to use computed tomography scans, patient demographics, and vertebral level to estimate the depth of the loss of resistance for placement of thoracic epidural catheters. Methods. The records of consecutive patients who received a thoracic epidural catheter were reviewed. Patient demographics, epidural placement site, and technique were collected. Preoperative computed tomography scans were reviewed to measure the skin to epidural space distance. Linear regression was used for a multivariate analysis. Results. The records of 218 patients were reviewed. The mean loss of resistance measurement was significantly larger than the mean computed tomography epidural space depth measurement by 0.79 cm (p < 0.001). Our final multivariate model, adjusted for demographic and epidural technique, showed a positive correlation between the loss of resistance and the computed tomography epidural space depth measurement (R (2) = 0.5692, p < 0.0001). Conclusions. The measured loss of resistance is positively correlated with the computed tomography epidural space depth measurement and patient demographics. For patients undergoing thoracic or abdominal surgery, estimating the loss of resistance can be a valuable tool.
背景与目的。以往的研究采用了多种方法来估计硬膜外导管置入前硬膜外腔的深度。我们旨在利用计算机断层扫描、患者人口统计学资料和椎体水平来估计胸段硬膜外导管置入时阻力消失的深度。方法。回顾接受胸段硬膜外导管置入的连续患者的记录。收集患者人口统计学资料、硬膜外置入部位和技术。回顾术前计算机断层扫描以测量皮肤至硬膜外腔的距离。采用线性回归进行多变量分析。结果。回顾了218例患者的记录。阻力消失测量的平均值比计算机断层扫描硬膜外腔深度测量的平均值显著大0.79厘米（p<0.001）。我们最终的多变量模型，经人口统计学和硬膜外技术校正后，显示阻力消失与计算机断层扫描硬膜外腔深度测量之间呈正相关（R（2）=0.5692，p<0.0001）。结论。测量的阻力消失与计算机断层扫描硬膜外腔深度测量及患者人口统计学资料呈正相关。对于接受胸腹部手术的患者，估计阻力消失可能是一种有价值的工具。
