Abdominal girth has a strong correlation with ultrasound-estimated epidural depth in parturients: a prospective observational study

Cantürk, Mehmet; Canturk, Fusun Karbancioglu; Kocaoğlu, Nazan; Hakki, Meltem

doi:10.1007/s00540-019-02621-9

Cited by 7 publications

(8 citation statements)

References 25 publications

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“…Studies performed to date have investigated various factors such as race, ethnic and geographical origins, age, gender, body weight, height, foot size, BMI, and BSA (body surface area). [16,17,18,19,20] In the study conducted by Cantürk M et al [21] on 130 pregnant women, the skin-to epidural space distance was measured with USG at the L3-4 intervertebral space. Then a combined epiduralspinal block was performed through this space, and the waist circumference, BMI, age, height, and body weight were recorded in all patients.…”

Section: Discussionmentioning

confidence: 99%

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The Effect of Preoperative Ultrasonography Imaging Method on Success in Patients with Thoracal Epidural Procedure

Kurum¹,

Şen²,

Tunçyürek³

et al. 2021

GKDA Derg

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Objective: To determine the actual measurement of skin-epidural distance in patients in whom epidural anesthesia would be applied at lower thoracic vertebral, and to examine the correlation of epidural space measurements made preoperatively with ultrasonography, and tomography with anthropometric values. Methods: Our prospective, randomized controlled study was realized with 96 ASA I-III adult patients who would undergo epidural anesthesia applied through epidural spaces between 9.-12. thoracic vertebras. Neck and waist circumferences, and BMIs of the patients were recorded. The thoracic level to be used was determined by the anesthesiologist, and marked after verified by USG. From the same thoracic level the distances between skin-spinous process, and skinligamentum flavum were measured with USG . After the procedure epidural needle was marked, and obtained values were recorded. Distances between skin-spinous process, and skin-lig. flavum were measured from CTs recorded in the archival files of the same patient. Results: In all three groups of patients ( T 9-10 [n=35], T 10-11 [n=30 and T 11-12 [n=31]) skin-lig. flavum distance measured with USG was statistically shorter than that measured with CT, and length of the epidural needle inserted through all levels (p<0,001). Only in the T9-10 group. skinlig.flavum distance measured in CT was statistically significantly shorter than the length of the needle inserted. Conclusion:With this study, it is shown for the first time in the literature that ultrasonography, CT and anthropometric measurements such as BMI, neck and waist circumference may be useful to estimate the skin-epidural depth before the epidural procedures performed at the lower thoracic levels (T9-12).

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Section: Discussionmentioning

confidence: 99%

“…During the procedure, these marks were considered as reference points. After that, the depth of the ligamentum flavum was measured,turning a linear (3)(4)(5)(6)(7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20)(21)(22) or convex (1-8 MHz) transducer medially and using a transverse median approach.…”

Section: Identifying the Intervertebral Levelmentioning

confidence: 99%

The Effect of Preoperative Ultrasonography Imaging Method on Success in Patients with Thoracal Epidural Procedure

Kurum¹,

Şen²,

Tunçyürek³

et al. 2021

GKDA Derg

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“…Cross-sectional imaging was carried out in the L2-3 intervertebral space to determine the ideal puncture point at the midpoint of L2-3 intervertebral space [ 11 ]. We also measured the depth of the epidural space and the distance between the midpoints of the T12-L1 and L2-3 intervertebral spaces.…”

Section: Methodsmentioning

confidence: 99%

Anatomical dimensions of the lumbar dural sac predict the sensory block level of continuous epidural analgesia during labor

Liu

Jin

et al. 2021

BMC Anesthesiol

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Background The anatomical dimensions of the lumbar dural sac determine the sensory block level of spinal anesthesia; however, whether they show the same predictive value during continuous epidural anesthesia (CEA) remains undetermined. We designed the present study to verify the efficacy of the anatomical dimensions of the lumbar dural sac in predicting the sensory block level during labor analgesia. Methods A total of 122 parturients with singleton pregnancies requesting labor analgesia were included in this study. The lumbar dural sac diameter (DSD), lumbar dural sac length (DSL), lumbar dural sac surface area (DSA), and lumbar dural sac volume (DSV) were measured with an ultrasound color Doppler diagnostic apparatus. CEA was performed at the L2-L3 interspace. After epidural cannulation, an electronic infusion pump containing 0.08% ropivacaine and sufentanil 0.4 μg/ml was connected. The sensory block level was determined with alcohol-soaked cotton, a cotton swab, and a pinprick. The analgesic efficacy of CEA was determined with a visual analog scale (VAS). The parturients were divided into two groups, “ideal analgesia” and “nonideal analgesia,” and the groups were compared by t test. Pearson’s correlation was performed to evaluate the association between the anatomical dimensions of the lumbar dural sac and sensory block level. Multiple linear regression analysis was used to create a model for predicting the sensory block level. Results In the ideal analgesia group, the height, DSL, DSA, DSV and DSD were significantly smaller, and the body mass index (BMI) was significantly larger (P < 0.05). In addition, the DSL demonstrated the strongest correlation with the peak level of pain block (r = − 0.816, P < 0.0001; Fig. 2A), temperature block (r = − 0.874, P < 0.0001; Fig. 3A) and tactile block (r = − 0.727, P < 0.0001; Fig. 4A). Finally, the multiple linear regression analysis revealed that DSL and BMI contributed to predicting the peak sensory block level. Conclusion In conclusion, our study shows that the sensory block level of CEA is higher when the DSL, DSA, DSV and DSD of puerperae are lower. DSL and BMI can be treated as predictors of the peak sensory block level in CEA during labor analgesia.

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“…Cross-sectional imaging was carried out in the L2-3 intervertebral space to determine the ideal puncture point at the midpoint of L2-3 intervertebral space [11] . We need to measure the depth of the epidural space and the distance between the midpoint of the intervertebral space between L1-2 and L2-3.…”

Section: Study Protocolmentioning

confidence: 99%

Anatomical Dimensions of the Lumbar Dural Sac Predict the Sensory Block Level of Continuous Epidural Analgesia during Labor

Liu

Jin

et al. 2021

Preprint

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Background: The anatomical dimensions of the lumbar dural sac determine the sensory block level of spinal anesthesia; however, whether they show the same predictive value during continuous epidural anesthesia (CEA) remains undetermined. We designed the present study to verify the efficacy of the anatomical dimensions of the lumbar dural sac in predicting the sensory block level during labor analgesia. Methods: A total of 122 parturients with singleton pregnancies requesting labor analgesia were included in this study. The lumbar dural sac diameter (DSD), lumbar dural sac length (DSL), lumbar dural sac surface area (DSA) , and lumbar dural sac volume (DSV) were measured with an ultrasound color Doppler diagnostic apparatus. CEA was performed at the L2-L3 interspace. After epidural cannulation, an electronic infusion pump containing 0.08% ropivacaine and sufentanil 0.4 µg/ml was connected. The sensory block level was determined with alcohol-soaked cotton, a cotton swab, and a pinprick. The analgesic efficacy of CEA was determined with a visual analog scale (VAS). Divided the parturients into two groups: "ideal analgesia" and "non-ideal analgesia", and compared the groups by t test. Pearson's correlation was performed to evaluate the association between the anatomical dimensions of the lumbar dural sac and sensory block level. Multiple linear regression analysis was used to create a model for predicting the sensory block level. Results: In the "ideal analgesia" group, the height, DSL, DSA, DSV and DSD were significantly smaller, and the BMI was significantly larger (P<0.05) (Table 1). In addition, the DSL demonstrated the strongest correlation with the peak level of pain block (r=-0.816, P<0.0001; Figure 2A), temperature block (r=-0.874, P<0.0001; Figure 3A) and tactile block (r=-0.727, P<0.0001; Figure 4A). Finally, multiple linear regression analysis revealed that the DSL and BMI contributed to predicting the peak sensory block level. Conclusion: In conclusion, our study shows that the sensory block level of CEA is higher when the DSL, DSA, DSV and DSD of puerpera are lower. The DSL and BMI can be treated as predictors of the peak sensory block level in CEA during labor analgesia.

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Abdominal girth has a strong correlation with ultrasound-estimated epidural depth in parturients: a prospective observational study

Cited by 7 publications

References 25 publications

The Effect of Preoperative Ultrasonography Imaging Method on Success in Patients with Thoracal Epidural Procedure

The Effect of Preoperative Ultrasonography Imaging Method on Success in Patients with Thoracal Epidural Procedure

Anatomical dimensions of the lumbar dural sac predict the sensory block level of continuous epidural analgesia during labor

Anatomical Dimensions of the Lumbar Dural Sac Predict the Sensory Block Level of Continuous Epidural Analgesia during Labor

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