Yamagami H, Hashizume K, Sha K, Furuya H, Okuda T
Department of Anesthesiology, Nara Medical University, Kashihara.
Masui. 1994 Feb;43(2):258-61.
Epidural block was performed in the same intervertebral space by both approaches with either flank position or prone position under fluoroscopy. The distances from with both positions the skin to the epidural space (SED) were compared. The prone position approach under fluoroscopy resulted in a significantly greater SED in both T2/3 puncture and L4/5 puncture groups. This was assumed to be due to the fact that the prone position approach does not always allow minimum distance. It was also thought to be due to the fact that in this position, compared with the flank position, a pillow is inserted under the thoracic (or abdominal) region, and the skin in the dorsal region is looser and the subcutaneous tissue is thicker. The lumbar vertebrae form the lordosis, and it does not disappear when the pillow is placed under the abdominal region. This causes the SED to be greater.
在透视引导下,采用两种入路在同一椎间隙进行硬膜外阻滞,患者取侧卧位或俯卧位。比较了两种体位下皮肤至硬膜外腔的距离(SED)。透视引导下的俯卧位入路在T2/3穿刺组和L4/5穿刺组中均导致SED显著增大。这被认为是由于俯卧位入路并不总是能实现最小距离。还认为这是因为在该体位下,与侧卧位相比,在胸(或腹)部区域下方放置了枕头,背部区域的皮肤更松弛且皮下组织更厚。腰椎形成前凸,当在腹部区域下方放置枕头时前凸不会消失。这导致SED更大。