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髋部/肩部宽度比与脊髓麻醉感觉平面关系的评估——一项前瞻性观察研究

Evaluation of Effect of Hip/Shoulder-Width Ratio on the Sensory Level of Spinal Anesthesia - A Prospective Observational Study.

作者信息

Shivashankar Archana, Rajappa Geetha Chamanahalli, Sudarshan Shruthi, Madhu M M, Rao Ridhi

机构信息

Department of Anaesthesiology, Ramaiah Medical College and Hospitals, Bengaluru, Karnataka, India.

出版信息

Anesth Essays Res. 2022 Jan-Mar;16(1):80-83. doi: 10.4103/aer.aer_146_21. Epub 2022 Jun 27.

Abstract

BACKGROUND

Certain anthropometric measurements that are practically obtainable explain the variability in the spread of spinal anesthesia. These are useful for quick assessment of the spread of spinal anesthesia to avoid the risk of high block and also the inadequate level of block.

AIMS

The study aims to evaluate the effect of hip/shoulder-width ratio (HSR) on the sensory level of spinal anesthesia.

SETTINGS AND DESIGN

This prospective observational study was undertaken at a tertiary care hospital.

STATISTICAL ANALYSIS

Pearson's correlation and multiple linear regression analyses were used to analyze the relationship between study variables with the level of sensory block.

MATERIALS AND METHODS

One hundred patients undergoing various surgical procedures were enrolled for the study. With a patient in a sitting position, hip-width was measured between the two iliac crests, shoulder-width was measured between two acromion processes, and vertebral column length was noted by measuring the distance from C vertebra to sacral hiatus. 3 mL of 0.5% hyperbaric bupivacaine was administered intrathecally at L-L with 25G Quincke's needle in the lateral position. Assessment of block level was done by loss of cold sensation and loss of pinprick sensation every 5 min till 30 min. The numbers of segments blocked were noted from the S segment. The relationship between various factors with the level of sensory block was analyzed by the Pearson's correlation coefficient.

RESULTS

HSR and body mass index (BMI) have a significant correlation with the sensory level of spinal anaesthesia, HSR (r = 0.297, < 0.05) and BMI (r =0.385, < 0.05).

CONCLUSION

HSR can help predict the cephalad spread of spinal anesthesia. We can expect a higher level of sensory blockade of spinal anesthesia in females who generally have an HSR more than one.

摘要

背景

某些实际可获取的人体测量数据可解释蛛网膜下腔麻醉扩散的变异性。这些数据有助于快速评估蛛网膜下腔麻醉的扩散情况,以避免高位阻滞风险以及阻滞平面不足的情况。

目的

本研究旨在评估髋/肩宽比(HSR)对蛛网膜下腔麻醉感觉平面的影响。

设置与设计

本前瞻性观察性研究在一家三级护理医院进行。

统计分析

采用Pearson相关性分析和多元线性回归分析来分析研究变量与感觉阻滞平面之间的关系。

材料与方法

招募100例接受各种外科手术的患者进行研究。患者取坐位,测量两侧髂嵴之间的髋宽、两侧肩峰之间的肩宽,并通过测量从颈椎到骶裂孔的距离记录脊柱长度。使用25G Quincke针在侧卧位L-L间隙鞘内注射3 mL 0.5%的高压布比卡因。每5分钟评估一次冷觉丧失和针刺觉丧失情况,直至30分钟,以评估阻滞平面。从S节段记录阻滞的节段数。通过Pearson相关系数分析各种因素与感觉阻滞平面之间的关系。

结果

HSR和体重指数(BMI)与蛛网膜下腔麻醉的感觉平面有显著相关性,HSR(r = 0.297,P < 0.05)和BMI(r = 0.385,P < 0.05)。

结论

HSR有助于预测蛛网膜下腔麻醉向头端的扩散。我们可以预期,通常HSR大于1的女性蛛网膜下腔麻醉的感觉阻滞平面会更高。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7c5c/9558681/8ffc07ee705a/AER-16-80-g001.jpg

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