A Prospective Observational Analytical Study to Evaluate the Variability of Skin Epidural Depth at Various Lumbar Spinal Levels Using Ultrasound
Journal Title: Indian Journal of Anesthesia and Analgesia - Year 2018, Vol 5, Issue 5
Abstract
Background: Epidural placement in lumbar spine is used to provide anaesthesia for surgeries below umbilicus. However the success depends on correct identification of epidural space taking into consideration anatomic variations. Studies have found that ultrasound is an useful tool to help in identification of the epidural space. Hence we used ultrasound to study the variability of skin to epidural space depth at various lumbar spinal levels. Study Method: We conducted a prospective observational study of 100 patients in age group of 40 to 60 years to compare the skin to epidural space depth (SED) at L1-L2,L2-L3 and L3-L4 space. We also compared the variation at these levels with respectto sex and BMI. Results and Conclusion: We found that the SED was highest at L3-L4 space with a mean distance of 4.15 +/-0.21cm from skin followed by L2-L3 (4.12 +/-0.22 cm) and least distance in L1-L2 space (4.1 +/-0.22cm). Age and sex had no correlation to the SED. However the SED had a significant correlation with the BMI (kg/m2) from which we could compute a formula. Mean (cm)=0.074(BMI)+2.534 where 0.074 is regression coefficient and 2.534 is a constant.
Authors and Affiliations
Manish Mohanlalji Kela
Keywords
Related Articles
- EP ID EP537922
- DOI 10.21088/ijaa.2349.8471.5518.13
- Views 67
- Downloads 0
Comparative Evaluation of the Incidence of Ventilator Associated Pneumonia in Intermittent Oral Suction Vs Continuous Subglottic Suction in Adult Neurosurgical Patient Requiring Mechanical Ventilation: A Randomized Control Trial
Introduction: Ventilator Associated Pneumonia (VAP) is the most common nosocomial infection in intensive care units (ICUs). The impaired host defenses and continuous exposure of the lower respiratory tract to large numbe...
A Comparative Study between Continuous Epidural Infusion and Continuous Femoral Nerve Block for Post-Operative Pain Relief in Total Knee Replacement Surgeries
Background: Postoperative pain management in TKR is of imperative importance. Epidural analgesia though considered as a standard technique in postoperative pain management in TKR it was commonly associated with unwanted...
Comparison of Two doses of Melatonin for Pre-Operative Anxiolysis in Adult Patients
This study was done to determine the efficacy of melatonin as a pre-operative anxiolytic and to compare the effect of two different doses of melatonin for the same. Settings and Design: This is a randomised double blinde...
Evaluation of Pre-emptive Intramuscular Glycopyrrolate in Prevention of Spinal Anesthesia Induced Hypotension in Elective Cesarean Sections
Context: Spinal anesthesia induced hypotension in parturients undergoing Cesarean section can be detrimental to both foetus and mother. Prophylactic administration of vasopressors helps in preventing hypotension thereby...
Comparison of 0.5% Bupivacaine with 0.5% Bupivacaine and Dexamethasone in Peribulbar Block for Small Incision Cataract Surgery: A Prospective Randomized Controlled Study
Objective: To compare the anesthetic efficacy and postoperative analgesia between 0.5% bupivacaine and 2mg dexamethasone and 0.5% bupivacaine alone in peribular block for small incision cataract surgery. Methods: 50 pati...