Anästhesie und klinische Forschung
Offener Zugang

Abstrakt

To Study the Correlation between Estimated Ultrasound Depth and Actual Needle Depth of Epidural Space in Transverse Plane in Parturients Undergoing Cesarean Section

Jyoti Kanwat

Background and aim: During pregnancy, edema and obesity obscure the anatomical landmark and because of this epidural space identification become difficult by conventional methods. Loose connective tissue also causes false loss of resistance and responsible for failed block and complications. This study was planned for USG (ultrasonography) guided puncture point detection and epidural space depth assessment and its correlation with actual needle insertion depth in obstetric patients.

Methods: Sixty four patients of ASA I and II for elective caesarean sections were included in this study. Lumbar space was identified by USG in which ligamentum-flavum with dura mater complex was taken as key structure for assessment of Ultrasound Depth (UD). This was followed by epidural needle insertion at the same marked point and measurement of epidural space Needle Depth (ND) taken. Concordance correlation coefficient and Bland Altman test were used to compare UD and ND.

Results: Mean ND and UD were respectively 3.63 ± 043 cm and 3.61 ± 0.17 and these distances were not significantly different (P>0.0001). Bland Altman analysis showed mean of difference between UD and ND to be insignificant (0.02). Significant concordance correlation r=0.96 (95% CI-0.94-0.9, p>0.0001) was observed between ND and UD.

Conclusion: In obstetric population pre puncture ultrasound scanning of lumbar spine helps in approximate assessment of epidural space depth and its correlate precisely with actual needle depth.