An Observational Study of the Relationship Between Lumbar Epidural Space Depth and Body Mass Index in Michigan Parturients

Clinkscales, C.P.; Greenfield, Mary Lou V. H.; Vanarase, M.; Polley, Linda S.

doi:10.1097/01.aoa.0000319779.62900.ce

Cited by 7 publications

(12 citation statements)

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“…Technical problems, such as difficulty in optimizing patient position and in identifying surface landmarks, prior to neuraxial block placement may have contributed to the longer OR-Sx time noted in Group III. A recent study showed a positive correlation with BMI and depth to epidural space, and included a review of earlier studies corroborating the association between BMI and depth to epidural space [14]. In our study, more Group III patients received a CSE technique than did the other study groups.…”

Section: Discussionsupporting

confidence: 67%

Retrospective analysis of anesthetic interventions for obese patients undergoing elective cesarean delivery

Butwick

Carvalho

Danial

et al. 2010

Journal of Clinical Anesthesia

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Section: Discussionsupporting

confidence: 67%

Retrospective analysis of anesthetic interventions for obese patients undergoing elective cesarean delivery

Butwick

Carvalho

Danial

et al. 2010

Journal of Clinical Anesthesia

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“…Furthermore, these results were similar to the findings of Hamilton et al [5], which showed that the epidural catheter moved significantly in obese patients. Several studies have reported that BMI has correlations with the SED [3,10]. BMI is not only a factor that affects the SED of parturients on ultrasound imaging, but it also influences changes in SED with patient movement from the sitting to the lateral position.…”

Section: Discussionmentioning

confidence: 99%

“…Pre-procedural lumbar ultrasound scanning is a reliable method to estimate the SED. Previous reports regarding the SED have been mostly retrospective reviews of clinical records concerning real needle depth [4,10]. In the past, it was impossible to assess the real needle depth multiple times with a single parturient.…”

Section: Introductionmentioning

confidence: 99%

The Skin-to-epidural distance of parturients by ultrasonography: sitting position versus left lateral position

et al. 2017

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This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.Background: Pre-procedural lumbar ultrasound scanning is a reliable tool to estimate the skin to epidural distance (SED). We conducted an observational study to compare the SED between the sitting position and lateral position using pre-procedural ultrasound imaging of the lumbar spine in parturients. Methods: Using a 2-5 MHz curvilinear transducer, we obtained images of the lumbar interspaces from L2-3 to L5-S1 in the paramedian sagittal oblique view. The individual distance from the skin to the ligamentum flavum-dura mater unit was measured at the level of L2-3, L3-4, L4-5, and L5-S1 in the left lateral position (distance in lateral position; D-lat). Subsequently, participants were placed in the sitting position, and the distance was measured in the same manner (distance in sitting position; D-sit). Data were grouped according to body mass index (BMI; kg/m 2 ) measurements of ≥ 25 or ＜ 25 and analyzed. The primary outcome was the change determined by ultrasound between D-lat and D-sit at the same lumbar level according to position. Results: Thirty parturients were studied. The difference between D-lat and D-sit in the same lumbar level was not statistically significant. The mean changes between D-lat and D-sit in the same lumbar level were less than 0.18 cm. In BMI ≥ 25 group, the difference between D-lat and D-sit were greater than that of BMI ＜ 25 group at L3-4 level (P = 0.042). Conclusions: It is important for clinicians to consider that position change is associated with greater differences in SED in obese parturients (BMI ≥ 25) compared with thin parturients (BMI ＜ 25). For obese parturients, the sitting position may be helpful.

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“…Karşılaşılan zorluklar komplikasyon riskini artırıp blok başarısını etkileyebilir. Epidural aralık derinliği BKİ ile ilişkili olup BKİ arttıkça cilt epidural aralık mesafesi artmaktadır 37 . Epidural aralığa yetişkinlerde 4-6 cm de ulaşılırken obez hastalarda 8 cm'de ulaşılabilmektedir.…”

Section: Rejyonel Anesteziunclassified

Obezite Hastalarında Anestezi Yönetimi

Uludağ¹,

Türktan²

2016

Arşiv Kaynak Tarama Dergisi

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Obesity has become a rapidly growing public health problem in whole world. Obesity and alterations due to obesity which include changes in metabolic, cardiovascular and pulmonary functions increase risk of perioperative mortality and morbidity. Obesity impacts anesthesia procedures significantly. Comorbid diseases such as hypertension, coronary artery disease, diabetes mellitus, and pulmonary diseases increase risk of complications during anesthesia. In this review we evaluated important factors that should be considered during planning of anesthesia for obesity surgery and other surgeries, management of intraoperative anesthesia and postoperative analgesia, and management of complications. Key words: Obesity, anesthesia management. ÖZETObezite, tüm dünyada giderek artan bir toplum sağlığı sorunu haline gelmiştir. Obezite ve obeziteye bağlı ortaya çıkan metabolik, kardiyovasküler ve pulmoner fonksiyonlar üzerinde değişiklikler, perioperatif mortalite ve morbidite riskini arttıran nedenlerdir. Obezite, anestezi uygulamalarını önemli ölçüde etkilemektedir. Vücut ağırlığının artması ile birlikte hava yolu yönetiminin zorlaşması başta olmak üzere hipertansiyon, koroner arter hastalıkları, diabetes mellitus, solunum yolu hastalıkları gibi yandaş hastalıklar anestezi riskini artırmaktadır. Bu derlemede; anestezi pratiğinde obezite cerrahisinde ve obezite dışı diğer cerrahilerde gün geçtikçe artan sayıda karşılaştığımız obez hasta popülasyonunda preoperatif anestezi planlamasında dikkat edilmesi gereken hususlar, intraoperatif anestezi yönetimi, postoperatif analjezi ve komplikasyonlar güncel bilgiler ışığında sunulmuştur. Anahtar kelimeler: Obezite, anestezi yönetimi.

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An Observational Study of the Relationship Between Lumbar Epidural Space Depth and Body Mass Index in Michigan Parturients

Cited by 7 publications

References 0 publications

Retrospective analysis of anesthetic interventions for obese patients undergoing elective cesarean delivery

Retrospective analysis of anesthetic interventions for obese patients undergoing elective cesarean delivery

The Skin-to-epidural distance of parturients by ultrasonography: sitting position versus left lateral position

Obezite Hastalarında Anestezi Yönetimi

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