Abdominal Girth, Vertebral Column Length, and Spread of Spinal Anesthesia in 30 Minutes after Plain Bupivacaine 5 mg/mL

Zhou, Qinghe; Xiao, Wu; Shen, Ying-yan

doi:10.1213/ane.0000000000000199

Cited by 27 publications

(46 citation statements)

References 17 publications

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“…As the VCL increases the spread of hyperbaric bupivacaine is limited to lower dermatome levels. Although these two previous studies were conducted with parturient patient population, in the current study we found similar correlation results in non pregnant patient population between VCL and the spread of spinal anaesthesia which is in accordance with the results of Zhou et al (9).…”

Section: Discussionsupporting

confidence: 93%

Hip/Shoulder Width Ratio Alters the Spread of Spinal Anesthesia: A Prospective Observational Study

Cantürk¹,

Hakki²,

Kocaoğlu³

2018

Ulutas Med J

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Introduction: Many factors have been tested to predict the spread of spinal anesthesia in clinical practice. In the study we aimed to investigate the correlation between hip/shoulder width ratio and spread of spinal anesthesia.Method: Sixty patients were enrolled in this study to determine the correlation between hip/shoulder width ratio and the spread of spinal anesthesia. The L4-L5 interspace, navigated by ultrasonography, was introduced at lateral position with a 25G spinal needle. 3ml 0,5% hyperbaric bupivacaine was injected intrathecal in 15 seconds. Age, height, weight, body mass index, hip/shoulder width ratio and vertebral column length were recorded. Spinal anesthesia spread was assessed at 0, 5, 10, 20, and 30 minutes after spinal anesthesia. Patient was turned supine 5 minutes after intrathecal injection. Multiple linear regression analysis was used to analyze correlation between the spread of spinal anesthesia and age, height, weight, hip/shoulder width ratio, vertebral column length.Results: The study was completed without dropout and sixty participants were included into analysis. There was a strong correlation between the spread of spinal anesthesia and hip/shoulder width ratio (r=0,766; p<0,0001) and a negative correlation with the height and vertebral column length (r= -0,572; -0,738 and p=0, 000; 0, 000 respectively).Conclusion: Cephalad spread of spinal anesthesia with a fixed dose of hyperbaric bupivacaine is strongly correlated with hip/shoulder width ratio and inversely correlated with height and vertebral column length. We may observe more spread with 0, 5% hyperbaric bupivacaine in patients with a greater hip/shoulder ratio and a shorter height.

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Section: Discussionsupporting

confidence: 93%

Hip/Shoulder Width Ratio Alters the Spread of Spinal Anesthesia: A Prospective Observational Study

Cantürk¹,

Hakki²,

Kocaoğlu³

2018

Ulutas Med J

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“…A high correlation between both abdominal girth and vertebral column length and lumbosacral cerebrospinal fluid volume was the primary finding of this study, which further explains the results of our previous studies . In our studies, we have demonstrated that abdominal girth and dorso‐sacral distance have a high predictive value for the spinal spread after a given dose of plain bupivacaine and can largely predict a suitable dose of plain bupivacaine for lower limb surgery.…”

Section: Discussionsupporting

confidence: 85%

“…In this study, the adjusted R 2 (0.644) for the regression equation between abdominal girth, dorso‐sacral distance and lumbosacral cerebrospinal fluid volume was lower than the adjusted R 2 for the regression equation between abdominal girth, vertebral column length and spinal spread in our previous study . This might be because that in current study the three‐dimensional volume of the lumbosacral cerebrospinal fluid was not the true sense of lumbosacral cerebrospinal fluid.…”

Section: Discussioncontrasting

confidence: 75%

“…In our previous study, we confirmed that physical characteristics of the patient, especially abdominal girth and vertebral column length, were highly correlated with the spread of spinal anaesthesia after a given dose of plain bupivacaine . The potential reason may be that there was a strong correlation between these physical characteristics and lumbosacral cerebrospinal fluid volume.…”

supporting

confidence: 72%

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Abdominal girth and dorso‐sacral distance can be used to estimate lumbosacral cerebral fluid volume

Zhou

Shen

Chen

2017

Acta Anaesthesiol Scand

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“…Chun et al (10) also found that IAP did not correlate with SAD. Although most of the studies have assessed abdominal obesity by measuring the abdominal girth in parturients (6,(12)(13)(14), Katulanda et al (15) suggested that the distance between the lower border of the xiphisternum and the center of the umbilicus could be used as an anthropometric measure to define abdominal obesity. Therefore, we decided to include the SPX as well as the SPF in our study.…”

Section: Discussionmentioning

confidence: 99%

The effects of uterine size with or without abdominal obesity on spinal block level and vasopressor requirement in elective cesarean section: a prospective observational study

Günüşen¹,

Sargın²,

Akdemir³

et al. 2019

Turk J Med Sci

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Introduction Spinal anesthesia is a safe, simple, rapid, effective, and easy-to-apply anesthetic technique for cesarean sections. Despite the advantages of spinal anesthesia, hypotension is a common complication with an incidence of 70%-85% in parturients (1-4). Many factors including the characteristics of the injected solution, patient position, age, height, weight, pregnancy, intraabdominal pressure (IAP), length of the vertebral column, and lumbosacral cerebrospinal fluid (CSF) volume determine the intrathecal spread of local anesthetics. In obstetric patients, physiological changes due to pregnancy, including changes in spinal curvature, venous pooling secondary to progesterone-induced decreases in vascular tone and aortocaval compression by the gravid uterus, contribute to hypotension during cesarean section under regional anesthesia (1-6). Many recent studies have addressed the effects of uterine size, abdominal girth, and IAP on sensory block level, ephedrine dose, and the incidence of hypotension in pregnant women. Large abdominal girth, big uterus, and increased IAP may be significant factors in greater cephalad spread of local anesthetics. The mechanisms explained in these studies are that the increased IAP secondary to the compression of the inferior vena cava due to the growing uterus leads to a reduction in CSF in the spinal canal (1,7-14). We hypothesized that there may be differences in the sensory block level and ephedrine requirements among pregnant women based on uterine size and the presence of abdominal obesity. The primary purpose of this study was to determine whether there is a relationship between uterine size and sensory block level and ephedrine dose in parturients receiving spinal anesthesia. Since Katulanda et al. (15) reported that the distance between the lower border of the xiphisternum and the center of the umbilicus could be used as an anthropometric measure to define abdominal obesity, we considered SPX to be a marker of both abdominal obesity and uterine size that contains abdominal obesity, easily identified anatomical landmarks Background/aim: Hypotension is a serious complication caused by spinal anesthesia that places both the mother and fetus at increased risk. We aimed to investigate the effects of uterine size with or without abdominal obesity on sensory block level of pregnant women receiving spinal anesthesia. Materials and methods: This study included 125 term parturients who underwent cesarean section. Motor and sensory block characteristics, the distance between the symphysis pubis and the fundus (SPF), the distance between the symphysis pubis and the xiphoid (SPX), newborn and placental weights, adverse effects, and doses of ephedrine were recorded. Results: Sensory block level and ephedrine dose were significantly correlated with the SPX and the combined newborn and placenta weights (P < 0.05). The incidence of hypotension was related to the SPX and the combined newborn and placenta weight (P < 0.05). There was no correlation between the SPF and sensory block leve...

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Abdominal Girth, Vertebral Column Length, and Spread of Spinal Anesthesia in 30 Minutes after Plain Bupivacaine 5 mg/mL

Abstract: Multiple regression analysis revealed that the combination of a patient's 5 general characteristics, especially abdominal girth and vertebral column length, had a high predictive value for the spread of spinal anesthesia after a given dose of plain bupivacaine.

Cited by 27 publications

References 17 publications

Hip/Shoulder Width Ratio Alters the Spread of Spinal Anesthesia: A Prospective Observational Study

Hip/Shoulder Width Ratio Alters the Spread of Spinal Anesthesia: A Prospective Observational Study

Abdominal girth and dorso‐sacral distance can be used to estimate lumbosacral cerebral fluid volume

The effects of uterine size with or without abdominal obesity on spinal block level and vasopressor requirement in elective cesarean section: a prospective observational study

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