2023, Number 2
<< Back Next >>
Acta Med 2023; 21 (2)
Correspondence of intervertebral space with neuroaxial blockade by palpation technique and ultrasound tracing
López GEI, Torres ACJ, Alfaro MLA
Language: Spanish
References: 10
Page: 111-114
PDF size: 157.60 Kb.
ABSTRACT
This article aims to identify the intervertebral localization by ultrasound of neuraxial blocks installed by palpation technique of anatomical references. To this end, a descriptive, cross-sectional, analytical observational study was conducted with 35 patients from the Hospital Sanatorio Durango between 18 and 60 years undergoing elective surgery with ASA I-III. After the elimination of the anesthetic residue, we performed ultrasonographic tracking. The analysis included frequencies, proportions, mean and SD, OR, and prevalence OR with 95% CI, T trend t χ
2 and χ
2 test (p < 0.05). Correspondence was 34.3%. Weight, height, BMI, BMI categories, position for blocking, and type of neuroaxial blockade did not have statistical significance (p > 0.05). In patients without correspondence, we found that 73.9% had cephalic localization. Using ultrasound, those without correspondence were L
1-L
2: 39.13%, L
2-L
3: 26.1%, L
3-L
4: 17.4%, two levels: 13.04 and T12-L
4: 4.35%. For this sample, the accuracy of the identification of the intervertebral space by the technique is poor, so the use of ultrasound can improve the installation. This type of research is essential since the continuous enhancement of anesthetic techniques will improve the prognosis of operated patients.
REFERENCES
Butterworth JF, Mackey SC, Wasnik J. Bloqueos espinales, epidurales y caudales. En: Ossio-Vela R, editor. Anestesiología clínica. 5a edición. México: Manual Moderno; 2014. pp. 825-857.
Hogan QH. Tuffier's line: the normal distribution of anatomic parameters. Anesth Analg. 1994; 78 (1): 194-195.
Hamandi K, Mottershead J, Lewis T, Ormerod IC, Ferguson IT. Irreversible damage to the spinal cord following spinal anesthesia. Neurology. 2002; 59 (4): 624-626.
Cook TM, Counsell D, Wildsmith JA; Royal College of Anaesthetists Third National Audit Project. Major complications of central neuraxial block: report on the Third National Audit Project of the Royal College of Anaesthetists. Br J Anaesth. 2009; 102 (2): 179-190.
Chin KJ, Perlas A, Chan V, Brown-Shreves D, Koshkin A, Vaishnav V. Ultrasound imaging facilitates spinal anesthesia in adults with difficult surface anatomic landmarks. Anesthesiology. 2011; 115 (1): 94-101.
Ellinas EH, Eastwood DC, Patel SN, Maitra-D'Cruze AM, Ebert TJ. The effect of obesity on neuraxial technique difficulty in pregnant patients: a prospective, observational study. Anesth Analg. 2009; 109 (4): 1225-1231.
Horsanali BO, Tekgul ZT, Ozkalkanli MY, Adibelli ZH, Esen O, Duran FY. Radiological evaluation of the line between the crista iliaca (Tuffier's line) in elderly patients. Turk J Anaesthesiol Reanim. 2015; 43 (3): 149-153.
Schlotterbeck H, Schaeffer R, Dow WA, Touret Y, Bailey S, Diemunsch P. Ultrasonographic control of the puncture level for lumbar neuraxial block in obstetric anaesthesia. Br J Anaesth. 2008; 100 (2): 230-234.
Parate LH, Manjunath B, Tejesh CA, Pujari V. Inaccurate level of intervertebral space estimated by palpation: the ultrasonic revelation. Saudi J Anaesth. 2016; 10 (3): 270-275.
Cruz ALA, Athié GJM, Martínez RVA, Martínez CFR. Localización adecuada del espacio intervertebral L3-L4 por palpación según el ultrasonido en voluntarios sanos. Acta Med. 2017; 15 (1): 25-31.