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产妇腹部周径与超声估计的硬膜外深度具有很强的相关性:一项前瞻性观察研究。

Abdominal girth has a strong correlation with ultrasound-estimated epidural depth in parturients: a prospective observational study.

机构信息

Department of Anesthesiology and Reanimation, Ahi Evran University Training and Research Hospital, Kırşehir, Turkey.

Department of Obstetrics and Gynecology, Ahi Evran University Training and Research Hospital, Kırşehir, Turkey.

出版信息

J Anesth. 2019 Apr;33(2):273-278. doi: 10.1007/s00540-019-02621-9. Epub 2019 Feb 8.

Abstract

BACKGROUND

Preprocedural ultrasound examination of vertebral column guides to locate desired intervertebral space and provides a prevision of needle trajectory and estimated needle depth in parturients. The objective of this study was to assess the correlation between ultrasound-estimated epidural depth (ED) with abdominal girth (AG), body mass index (BMI), weight, height, and age.

METHODS

In this prospective, observational study, ultrasound imaging was done at L3-4 interspace in transverse median plane (TP) and paramedian sagittal oblique plane (PSO) to obtain ultrasound estimates of skin to epidural space depth. Combined spinal epidural anesthesia was performed at L3-4 interspace. AG, BMI, age, height, and weight were recorded for every parturient.

RESULTS

Data from 130 parturients were analyzed. Estimated ED was 56.5 ± 9.5 mm in TP, 57.5 ± 9.3 mm in PSO, and actual epidural depth was 57.9 ± 9.4 mm. Correlation coefficients between ED and AG were 0.797 in TP (95% CI 0.727-0.854, p < 0.001) and 0.803 in PSO (95% CI 0.733-0.857, p < 0.001). Correlation coefficients between ED and BMI were 0.543 in TP (95% CI 0.405-0.661, p < 0.001) and 0.566 in PSO (95% CI 0.428-0.680, p < 0.001). Correlation coefficients between ED and weight were 0.593 in TP (CI = 0.466-0.695, p < 0.001) and 0.615 in PSO (CI = 0.500-0.716, p < 0.001). Height and age had no significant correlation with ED.

CONCLUSIONS

Abdominal girth has a strong correlation with ultrasound-estimated epidural depth in parturients.

摘要

背景

脊柱术前超声检查可定位目标椎间间隙,并预测产妇的进针轨迹和估计进针深度。本研究的目的是评估超声估计的硬膜外深度(ED)与腹围(AG)、体重指数(BMI)、体重、身高和年龄之间的相关性。

方法

在这项前瞻性、观察性研究中,在 L3-4 椎间水平的横正中平面(TP)和旁正中矢状斜平面(PSO)进行超声成像,以获得皮肤至硬膜外空间深度的超声估计值。在 L3-4 椎间水平进行联合脊髓-硬膜外麻醉。记录每位产妇的 AG、BMI、年龄、身高和体重。

结果

对 130 名产妇的数据进行了分析。TP 处的估计 ED 为 56.5±9.5mm,PSO 处为 57.5±9.3mm,实际硬膜外深度为 57.9±9.4mm。ED 与 AG 之间的相关系数在 TP 为 0.797(95%CI 0.727-0.854,p<0.001),PSO 为 0.803(95%CI 0.733-0.857,p<0.001)。ED 与 BMI 之间的相关系数在 TP 为 0.543(95%CI 0.405-0.661,p<0.001),PSO 为 0.566(95%CI 0.428-0.680,p<0.001)。ED 与体重之间的相关系数在 TP 为 0.593(CI=0.466-0.695,p<0.001),PSO 为 0.615(CI=0.500-0.716,p<0.001)。身高和年龄与 ED 无显著相关性。

结论

腹围与产妇超声估计的硬膜外深度有很强的相关性。

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