An observational study of the relationship between lumbar epidural space depth and body mass index in Michigan parturients

Warman, Paul; Youngs, P.

doi:10.1016/j.ijoa.2008.01.014

Cited by 2 publications

(3 citation statements)

References 2 publications

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“…There were no significant differences between the two groups. The mean depth to the epidural space from the skin has been recorded as 4.6–5.3 cm in a Michigan parturient[ 18 , 19 ]; in this study, we found that the mean depth to the epidural space from the skin was 4.1-4.7 cm in a Beijing parturient.…”

Section: Discussionsupporting

confidence: 46%

Preprocedure ultrasound imaging combined with palpation technique in epidural labor analgesia

Wu¹,

Tang²,

He³

et al. 2021

WJCC

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BACKGROUND For parturients with paroxysmal uterine contraction pain, rapid analgesia is needed. We used preprocedure ultrasound imaging combined with the palpation technique in epidural analgesia for labor, and evaluated the usefulness of this technique in epidural labor analgesia. AIM To evaluate the usefulness of preprocedure ultrasound imaging in epidural analgesia for labor. METHODS In this prospective randomized observational study, 72 parturients were assigned to two groups (combined or palpation group). The target interspace of all parturients was first identified by the palpation technique. Then in the combined group, preprocedure ultrasound imaging was used before epidural puncture. In the palpation group, only the traditional anatomical landmarks technique (palpation technique) was performed. The primary outcome was total duration of the epidural procedure (for the ultrasound group, the duration of the preprocedure ultrasound imaging was included). The secondary outcomes were the number of skin punctures, the success rate at first needle pass, the number of needle passes, the depth from the skin to epidural space, and the complications of the procedure. RESULTS Total duration of the epidural procedure was similar between the two groups (406.5 ± 92.15 s in the combined group and 380.03 ± 128.2 s in the palpation group; P = 0.318). A significant improvement was demonstrated for epidural puncture and catheterization in the combined group. The number of needle passes was 1.14 in the combined group and 1.72 in the palpation group ( P = 0.001). The number of skin puncture sites was 1.20 in the combined group and 1.25 in the palpation group ( P = 0.398). The success rate at first needle pass was 88.89% in the combined group and 66.67% in the palpation group ( P = 0.045). CONCLUSION This study demonstrated that the total duration of epidural procedures with preprocedure ultrasound imaging combined with the palpation technique was not longer than the traditional anatomical landmarks technique, which were performed by six experienced anesthesiologists in parturients with normal weights undergoing labor analgesia.

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Section: Discussionsupporting

confidence: 46%

Preprocedure ultrasound imaging combined with palpation technique in epidural labor analgesia

Wu¹,

Tang²,

He³

et al. 2021

WJCC

View full text Add to dashboard Cite

show abstract

“…Using up-to-date ultrasound equipment and the paramedian approach, the spinal anatomy was easily identified. Ultrasonography has gained more popularity in daily anesthetic practice for both vascular access and regional anesthesia [3,8,16,17]. Spinal sonoanatomy is complicated by the surrounding bony structure, but the use of a modern ultrasound machine is a promising technique to obtain better image quality of the spinal sonoanatomy and assist neuraxial blocks [11,18].…”

Section: Discussionmentioning

confidence: 99%

“…Although an ultrasound imaging for central neuraxial block is complicated by the surrounding bony structure [3], the spinal sonoanatomy could be more easily detectable with modern ultrasound unit [1,4e7]. Its utility for either prepuncture evaluation or real-time guidance has been reported to improve puncture quality or learning curves for central neuraxial block [8,9]. The depth of epidural space and its related demographic factors have been demonstrated recently [10].…”

Section: Introductionmentioning

confidence: 99%

Lumbar epidural space was narrower in parturients than that in nonpregnant women by ultrasound assessment

Huang

Hsu

et al. 2011

The Kaohsiung J of Med Scie

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Labor epidural is commonly used to provide both regional anesthesia and postoperative pain relief. Epidural space is supposed to be narrower and deeper in a parturient than that in a nonpregnant woman. The aim of this study was to explore the difference of epidural spaces between parturient and nonpregnant women by ultrasound assessment. Thirty nonpregnant female volunteers and 30 parturients undergoing labor epidurals were enrolled to receive ultrasound examination. A low-frequency (2-5 MHz) curved-array ultrasound probe was used to obtain spinal sonoanatomy for each subject. The longitudinal paramedian scanning plane was used to obtain optimal ultrasound image for spinal sonoanatomy. Primary outcome was evaluated by the diameter and depth of epidural space at three lumbar interspaces (from L2 to L5). The quality of ultrasound images was also compared between the groups by a numerical scoring system (from 0 to 3). The mean diameters of lumbar epidural spaces were 3.03 ± 0.45 mm and 4.44 ± 0.49 mm (p<0.05) for parturients and nonpregnant women, respectively. The mean depths of lumbar epidural spaces for parturients and nonpregnant women were 3.53 ± 0.62 cm and 3.25 ± 0.63 cm, respectively (p<0.05). The mean scores for epidural space image quality were 2.58 ± 0.58 and 2.63 ± 0.53 for parturients and nonpregnant women, respectively (p=0.08). Epidural space is narrower and deeper at lumbar interspaces in obstetrics by ultrasound examination. The quality of ultrasound images did not differ significantly between the groups. These quantitative results improve the understanding of the differences between two groups that have been previously known qualitatively and may help in avoiding complications.

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An observational study of the relationship between lumbar epidural space depth and body mass index in Michigan parturients

Cited by 2 publications

References 2 publications

Preprocedure ultrasound imaging combined with palpation technique in epidural labor analgesia

Preprocedure ultrasound imaging combined with palpation technique in epidural labor analgesia

Lumbar epidural space was narrower in parturients than that in nonpregnant women by ultrasound assessment

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