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

• Published in: Anesthesia and pain medicine (Korean society of anesthesiologists) Vol. 12; no. 2; pp. 132 - 136
• Main Authors: Chun, Eun Hee, Chung, Rack Kyung, Kim, Youn Jin, Jin, So Hee
• Format: Journal Article
• Language: English
• Published: 대한마취통증의학회 30.04.2017
• Subjects: 마취과학
• ISSN: 2383-7977; 1975-5171; 2383-7977
• DOI: 10.17085/apm.2017.12.2.132

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/m2) 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. KCI Citation Count: 0