Department of Anesthesiology and Intensive Care Medicine, Nagoya City University Graduate School of Medical Sciences, 1 Kawasumi, Mizuho-cho, Mizuho-ku, Nagoya, 467-8601, Japan.
J Anesth. 2022 Apr;36(2):270-275. doi: 10.1007/s00540-022-03045-8. Epub 2022 Feb 10.
We aimed to investigate intersected vertebral level changes in the palpated intercristal line (PI-line) when shifting from a sitting to a lateral decubitus position in parturients.
We consecutively enrolled parturients with a gestational age of ≥36 weeks. The attending anesthesiologists palpated the superior aspects of the posterior iliac crests bilaterally in a sitting position and then in a lateral decubitus position. The blinded investigators performed the ultrasound and recorded the intersected segment level of the PI-line. The distance between any two consecutive vertebral interspaces was divided into 3 segments, and comparisons were made with 15 segments of five vertebral interspaces above the sacrum. The primary outcome was the concordance rate of intersected segment level of the PI-line between the two positions. We also examined the intersected segment level of the PI-line of the two positions and the magnitude of these changes.
Thirty-nine parturients were analyzed. The concordance rate of intersected segment levels of the PI-line between the two positions was 21% (8/39). In 56% (22/39) of the parturients, the intersected segment level of the PI-line in the sitting position was more cephalad and 23% (9/39) were more caudal. Fifteen percent (6/39) of parturients had three or more segment differences between the two positions.
The intersected segment level of the PI-line, measured with trisected segments in each vertebral interspace, was different between the sitting and the lateral decubitus positions in approximately 80% of the parturients. Notably, 15% (6/39) of the parturients had at least one vertebral interspace deviation.
本研究旨在探讨产妇从坐位切换至侧卧位时,触诊髂嵴后上缘连线(PI 线)在相交椎骨节段的变化。
连续纳入妊娠 36 周及以上的产妇。麻醉医生在坐位下双侧触诊髂嵴后上缘,然后切换至侧卧位。由盲法研究者进行超声检查,并记录 PI 线相交节段的水平。将每个椎间隙之间的距离分为 3 个节段,与骶骨上 5 个椎间隙的 15 个节段进行比较。主要结局为两种体位下 PI 线相交节段的符合率。我们还检查了两种体位下 PI 线相交节段的水平以及这些变化的幅度。
共 39 例产妇纳入分析。两种体位下 PI 线相交节段的符合率为 21%(8/39)。56%(22/39)的产妇坐位 PI 线相交节段更头侧,23%(9/39)的产妇更尾侧。15%(6/39)的产妇两种体位间相差 3 个或更多节段。
PI 线的相交节段水平在坐位和侧卧位之间存在差异,约 80%的产妇存在这种差异。值得注意的是,15%(6/39)的产妇至少有一个椎间隙存在偏差。