Zhou Q H, Shen C, Chen G
Department of Anesthesiology, Second Affiliated Hospital, Jiaxing University, Jiaxing, China.
The First clinical medical college, Nanjing Medical university, Nanjing, China.
Acta Anaesthesiol Scand. 2018 Feb;62(2):234-241. doi: 10.1111/aas.13046. Epub 2017 Nov 27.
Patients' abdominal girth and vertebral column length are highly correlated with the spread of local anaesthetics after spinal anaesthesia. Lumbosacral cerebrospinal fluid volume is the primary determinant for spinal spread. Thus, we attempted to verify the hypothesis that abdominal girth and dorso-sacral distance are correlated with lumbosacral cerebrospinal fluid volume.
Forty-five healthy volunteers were enrolled in this study to measure lumbosacral cerebrospinal fluid volume using magnetic resonance imaging. The age, height, weight, abdominal girth, dorso-sacral distance and lumbosacral cerebrospinal fluid volume of the volunteers were recorded. Multiple linear regression analysis was used to analyse the correlation between age, height, weight, abdominal girth, dorso-sacral distance and lumbosacral cerebrospinal fluid volume.
Two volunteers were excluded because of lumbar disc herniation, leaving 43 volunteers for analysis. Multiple linear regression analysis showed a strong correlation between abdominal girth, dorso-sacral distance and lumbosacral cerebrospinal fluid volume (both P < 0.01). The adjusted R was 0.644. Volunteers with small abdominal girth showed clear images of cerebrospinal fluid in the nerve root cuff at the intervertebral foramen in the three-dimensional magnetic resonance imaging reconstruction of lumbosacral cerebrospinal fluid, while the images were vague in volunteers with large abdominal girth. Clearer images implied larger lumbosacral cerebrospinal fluid volume, while vaguer images, smaller lumbosacral cerebrospinal fluid volume.
Multiple regression analysis revealed that abdominal girth and dorso-sacral distance were correlated with lumbosacral cerebrospinal fluid volume. Smaller abdominal girths and larger dorso-sacral distances predict larger lumbosacral cerebrospinal fluid volume.
患者的腹围和脊柱长度与脊髓麻醉后局部麻醉药的扩散高度相关。腰骶部脑脊液容量是脊髓扩散的主要决定因素。因此，我们试图验证腹围和腰骶部距离与腰骶部脑脊液容量相关的假设。
本研究纳入45名健康志愿者，采用磁共振成像测量腰骶部脑脊液容量。记录志愿者的年龄、身高、体重、腹围、腰骶部距离和腰骶部脑脊液容量。采用多元线性回归分析年龄、身高、体重、腹围、腰骶部距离与腰骶部脑脊液容量之间的相关性。
两名志愿者因腰椎间盘突出症被排除，剩余43名志愿者进行分析。多元线性回归分析显示腹围、腰骶部距离与腰骶部脑脊液容量之间存在强相关性（均P<0.01）。调整后的R为0.644。腹围小的志愿者在腰骶部脑脊液的三维磁共振成像重建中，椎间孔神经根袖处脑脊液图像清晰，而腹围大的志愿者图像模糊。图像越清晰意味着腰骶部脑脊液容量越大，图像越模糊，腰骶部脑脊液容量越小。
多元回归分析显示腹围和腰骶部距离与腰骶部脑脊液容量相关。较小的腹围和较大的腰骶部距离预示着较大的腰骶部脑脊液容量。
