Strategies to reduce neuraxial analgesia failure during labour

Ong, Jocelyn; Kirthinanda, Dinoo; Loh, Samuel Kent Neng; Sng, Ban Leong

doi:10.1016/j.tacc.2016.05.006

Cited by 1 publication

(2 citation statements)

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“…In morbidly obese parturient women, the combination of an ultrasound with pre-procedural epidural depth equations that are determined from height and weight variables improved the success rate of the epidural catheter placement than with ultrasonography alone [9]. However, the equations that were generated from individual studies have not been validated to other patient populations, therefore, their use is limited to within the same study population [8]. Conversely, the present study validated existing equations by demonstrating good agreement and correlation with an alternative unrelated study population [12].…”

Section: Discussionmentioning

confidence: 99%

“…In particular, the relationship between anthropometric variables and the body mass index have been shown to have positive correlations with the skin to lumbar epidural space distance [3][4][5][6][7]. Pre-procedural knowledge of the depth of the epidural space from the skin may serve as a guide for needle placement, particularly for less experienced operators [8,9].…”

Section: Introductionmentioning

confidence: 99%

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Mathematical Models for the Skin to Lumbosacral Epidural Distance in Dogs: A Cadaveric Computed-Tomography Study

Sun

Schier

Lau

et al. 2021

Animals

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This study aimed to validate previously published computed tomography (CT) derived mathematical equations with the true skin to lumbosacral epidural distance (SLED) in dog cadavers. Phase 1: The lumbar region of 11 dog cadavers were scanned in sternal recumbency to determine the effect of cranial, neutral, and caudal pelvic limb positioning on the CT derived lumbosacral epidural distance (CLED). Phase 2: The epidural space was determined using contrast epidurography, and the SLED was analysed against the mathematical equations using a body condition score (BCS) and either the cadaveric occipital-coccygeal length (OCL) (Equation (1): = 7.3 + 0.05*OCL + 16.45*BCS) or the ilium wing distance (IWD) (Equation (2): = 3.5 + 0.56*IWD + 16.6*BCS). There were no differences detected between the pelvic limb positions and the CLED. Both equations demonstrated strong correlations (Equation (1): r = 0.7196; Equation (2): r = 0.7590) with the SLED. The level of agreement was greater for Equation (1) than with Equation (2) (concordance coefficient 0.6061 and 0.3752, respectively). Equation (1) also demonstrated a closer fit to the concordance line compared with Equation (2) (bias correction factor 0.8422 and 0.4960, respectively). Further studies in live anaesthetised dogs will help to determine the usefulness of the pre-procedural knowledge when performing lumbosacral epidurals.

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Section: Discussionmentioning

confidence: 99%