DOI: http://dx.doi.org/10.18203/2349-3933.ijam20205046

Correlation of distance from skin to lumbar epidural space with age and height of patients

Manju Bala, Monica Chhikara, Deepika ., Kiranpreet kaur, Teena Bansal, Sabiha Naz

Abstract


Background: Epidural block is a popular and versatile procedure with applications as sole anaesthetic, as an analgesic adjuvant to general anaesthesia and for post-operative analgesia in procedures involving lower limbs, perineum, pelvis, abdomen and thorax. However, success of the epidural technique depends upon the correct identification of epidural space. The knowledge of distance from skin to epidural space can help in better identification of epidural space and epidural catheter placement with fewer incidences of complications. We conducted a study to find the distance from skin to the epidural space and its correlation with patient height and age to improve the success rate.  

Methods: Seventy-four patients scheduled to undergo lower lumbar surgeries where epidural block was required as anaesthetic or analgesic, were included in the study. These patients were randomly divided into four different groups of 37 patients each according to their age (group A and group B) and height (group C and group D). In these patient’s epidural block was given by standard technique according to the need of surgery and epidural depth measured. Obtained results were compared among group A, B and group C, D depending on their age and height respectively.  

Results: In group A (age 20-30 years), mean epidural depth was 3.96±0.4 cm while in group B (age 30-40 years) mean epidural depth was 4.05±0.5 centimeters. In group C (height 155-169 cm) mean epidural depth was 3.88±0.4 centimeters while it was 4.13±0.5 centimeters in group D (height 170-184 cm).

Conclusions: There was increase in epidural depth with increase in height of patients but there was no correlation between age of patients and epidural depth.


Keywords


Epidural depth, Age, Height

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References


Visser L. Epidural anaesthesia. Updates in Anaesthesia. 2001;13:1-4.

Brown DL. Spinal, epidural and caudal Anesthesia. In: Miller RD, Eriksson LI, Fleisher LA,Wiener kronish JP, Young WL, editors. Miller’s Anesthesia. 7thed. Philadelphia: Churchill Livingstone; 2010:1614-5.

Collins VJ. Epidural anesthesia. In: Collins VJ, editor. Principles of anesthesiology: general and regional anesthesia. 3rd ed. USA: Lea and Febiger; 1993:1571.

Dawkin M. The identification of the epidural space. Anaesthesia. 1963;18:66-76.

Parekh A, Dias R, Dave N. Correlation between skin epidural space distance with weight age and height in paediatric patients. Indian J Anaesth. 2019;63:143-6.

Mc Conachie I, Mc Gaechie John, Barrie J. Regional anesthetic techniques. In: Healy TEJ, Knight PR, editors. Arnold. 7th ed. Wylie and Churchill Davidsons: A Practice of Anaesthesia; 2003.

Adegboye MB, Bolaji BO, Ibraheem GH. The Correlation Between Body Mass Index on The Length From Skin To Lumbar Epidural Space In Nigerian Adults. J West Afr Coll Surg. 2017;7:113-27.

Hirabayashi Y, Matsuda I, Inowe S, Shimizu R. The distance from the skin to the epidural space. J Clin Anaesth. 1988;2:198-201.

Rosenberg H, Keykhak MM. Distance to the epidural space in Non- obstetric patients. Anesth Analg. 1984;63:538-46.

Shiroyama K, Izumi H, Kubo T, Nakamura R. Distance from the skin to epidural space at the first lumbar interspace in a Japanese obstetric population. Hiroshima J Med Sci. 2003;52:27-9.

Ravi KK Kaul, TK Kathuria S, Gupta S, Khurana S. Distance from skin to epidural space: correlation with body mass index (BMI). J Anaesthesiol Clinic Pharmacol. 2011;27:39-42.