Preprocedural ultrasound estimates of epidural depth: transverse median plane is comparable to paramedian sagittal oblique plane in non-pregnant patients [Turk J Anaesthesiol Reanim]
Turk J Anaesthesiol Reanim. Ahead of Print: TARD-92342

Preprocedural ultrasound estimates of epidural depth: transverse median plane is comparable to paramedian sagittal oblique plane in non-pregnant patients

mehmet cantürk1, Nazan Kocaoglu2, Meltem Hakký1
1Department of Anesthesiology and Reanimation, Kirsehir Ahi Evran University Training and Research Hospital, Kirsehir, Turkey
2Department of Anesthesiology and Reanimation, Balikesir University Faculty of Medicine, Balikesir, Turkey

Objective: We aimed to assess the accuracy and precision between actual epidural depth (ND) and the ultrasound estimates of skin to epidural space depth in transverse median plane (ED/TM) and paramedian sagittal oblique plane (ED/PSO) in non-pregnant patients undergoing unilateral inguinal hernia repair surgery with combined spinal epidural anesthesia.
Methods: One hundred American Society of Anesthesiology status I-III patients of either sex were recruited. All epidurals were inserted at L3 - 4 intervertebral space and epidural needle was marked with a sterile marker. ND was measured between the marker and the tip of the needle. ED/TM and ED/PSO were assessed with a 2 - 5 MHz curved array probe at L3 - 4 intervertebral space. Pearson correlation coefficient and Lin’s concordance correlation coefficient were used to assess the precision and Bland-Altman test was used to assess 95% limits of agreement.
Results: ND was 48.98 ± 6.91mm, ED/PSO was 48.92 ± 6.91mm, and ED/TM was 48.90 ± 6.91mm. Pearson correlation coefficient between ND and ED/PSO was 0.995 (p < 0.001) and 0.994 (p < 0.001) with ED/TM. Lin’s concordance correlation coefficient for ND and ED/PSO was 0.995 (95%CI = 0.992 – 0.997), and 0.993 for ND and ED/TM (95% CI = 0.990 – 0.996). The 95% limits of agreement between ND and ED/PSO was 0.70 – 1.37 and 0.79 – 1.54 for ND and ED/TM.
Conclusion: Preprocedural ultrasound scanning in both planes provides reliable estimates for actual epidural depth in non-pregnant patient population.

Keywords: : Epidural depth, paramedian sagittal oblique, transverse median, ultrasound




Corresponding Author: mehmet cantürk, Türkiye


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