A Prospective, Observational Study of the Relationship Between Body Mass Index and Depth of the Epidural Space During Lumbar Transforaminal Epidural Steroid Injection

Brummett, Chad M.; Williams, Bryan S.; Hurley, Robert W.; Erdek, Michael

doi:10.1097/aap.0b013e31819a12ba

Cited by 21 publications

(17 citation statements)

References 20 publications

(15 reference statements)

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“…In a more recent study, Brummett et al. concluded that the distance from skin to lumbar epidural space measured via a transforaminal approach (similar to the paramedian approach) is greater than that obtained via an interlaminar approach [13]. Our study addresses these sources of bias by exclusion of labour epidurals performed in the lateral position and via the paramedian approach.…”

Section: Discussionmentioning

confidence: 92%

Effect of ethnicity and body mass index on the distance from skin to lumbar epidural space in parturients

Sharma¹,

Swinson²,

Hughes³

et al. 2011

Anaesthesia

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SummaryWith the current prevalence of obesity and trends in ethnic diversity amongst parturients in UK maternity units, we performed a prospective, observational study to establish the effect of ethnicity and body mass index on the distance from skin to epidural space in parturients. A total of 1210 parturients participated in this study. The mean (SD) distance from skin to lumbar epidural space was 5.4 (1.1) cm. When tested in a multiple regression model, both body mass index and ethnicity significantly influenced the distance from skin to lumbar epidural space in parturients. The distance from skin to lumbar epidural space amongst ethnic groups differed at any given body mass index. It was significantly greater in Black ⁄ British Black and White parturients compared with their Asian and Chinese counterparts.

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Section: Discussionmentioning

confidence: 92%

Effect of ethnicity and body mass index on the distance from skin to lumbar epidural space in parturients

Sharma¹,

Swinson²,

Hughes³

et al. 2011

Anaesthesia

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“…The procedures were performed according to the subpedicular transforaminal technique (ISIS Practice Guidelines [23]). The patient was positioned prone and skin was prepped with sterile technique.…”

Section: Methodsmentioning

confidence: 99%

“…For example, Brummett et al [23] found that needle length increases with BMI when performing TFESI, and practitioners anecdotally report increased difficulty controlling longer length needles. Additionally, interventionalists often report increased difficulty visualizing targets when performing TFESI in individuals with a larger body habitus.…”

Section: Introductionmentioning

confidence: 99%

Lumbosacral transforaminal epidural steroid injections are equally effective for treatment of lumbosacral radicular pain in the obese compared to non-obese population: A pilot study1

McCormick

Plastaras

2013

BMR

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“…En las pacientes embarazadas obesas se pueden presentar mayores dificultades técnicas para la punción neuroaxial en comparación con las de peso normal, por mala identificación de reparos anatómicos (línea media de la columna vertebral, línea intercrestal o de Tuffier, espacios intervertebrales, etc.) y aumento de la distancia entre la piel y el espacio epidural (31,32), lo que generaría mayor número de intentos durante la punción espinal y epidural (33). Por otro lado, en las embarazadas obesas existe mayor incidencia de desplazamiento del catéter epidural, falsos positivos generados por el panículo adiposo cuando se utiliza la técnica de pérdida de resistencia para la localización del espacio epidural, mayor incidencia de punción venosa peridural y de meninges (34), y mayor dificultad en el posicionamiento de la paciente previo a la realización de la punción neuroaxial.…”

Section: Anestesia En El Trabajo De Partounclassified

Obesidad y embarazo: implicancias anestésicas

et al. 2014

Rev. chil. obstet. ginecol.

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RESUMENLa obesidad es una epidemia a nivel mundial, con más de 2.000 millones de adultos con sobrepeso u obesidad, por lo que cada vez es más probable enfrentarse a una embarazada obesa en la práctica clínica del equipo obstétrico. La obesidad incrementa los cambios fisiológicos del embarazo a nivel cardiovascular, respiratorio, metabólico y gastrointestinal, lo que tiene implicancias clínicas que aumentan los costos en salud y la morbimortalidad materna y fetal. Las embarazadas obesas son un constante desafío para el equipo obstétrico, anestesiológico y de salud, debiendo ser enfrentadas de forma multidisciplinaria para la obtención de mejores resultados obstétricos y perinatales. El anestesiólogo debe tener especial cuidado en el manejo analgésico del trabajo de parto y en la técnica anestésica para la operación cesárea. El objetivo central de la siguiente revisión es explicar, analizar y desarrollar las principales implicancias anestésicas a las cuales se ve enfrentado el especialista en una embarazada obesa. SUMMARYObesity is a global epidemic, with more than 2,000 million overweight or obese adults, so it is very likely to have an obese pregnant in the clinical practice of the anesthesiologist. Obesity increases the physiological changes of pregnancy in the cardiovascular, respiratory, metabolic and gastrointestinal system, which has clinical implications that increase health care costs and maternal and fetal morbidity and mortality. Obese pregnant are a constant challenge for the obstetric, anesthesiology and health team, and must be considerate in a multidisciplinary way to obtain better maternal and perinatal outcomes. The anesthesiologist should take special care in the labor analgesia and anesthetic technique for caesarean section. The focus of the following review is to present and develop the main anesthetic implications to which the anesthesiologist is confronted in obese pregnant patient.

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A Prospective, Observational Study of the Relationship Between Body Mass Index and Depth of the Epidural Space During Lumbar Transforaminal Epidural Steroid Injection

Cited by 21 publications

References 20 publications

Effect of ethnicity and body mass index on the distance from skin to lumbar epidural space in parturients

Effect of ethnicity and body mass index on the distance from skin to lumbar epidural space in parturients

Lumbosacral transforaminal epidural steroid injections are equally effective for treatment of lumbosacral radicular pain in the obese compared to non-obese population: A pilot study1

Obesidad y embarazo: implicancias anestésicas

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