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.
J Anesth. 2019 Apr;33(2):273-278. doi: 10.1007/s00540-019-02621-9. Epub 2019 Feb 8.
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.
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.
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.
Abdominal girth has a strong correlation with ultrasound-estimated epidural depth in parturients.
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。
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。
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。
腹围与产妇超声估计的硬膜外深度有很强的相关性。