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Anatomical dimensions of the lumbar dural sac predict the sensory block level of continuous epidural analgesia during labor
BMC Anesthesiology ( IF 2.2 ) Pub Date : 2021-11-04 , DOI: 10.1186/s12871-021-01485-5
Chen-Yang Xu 1, 2 , Can Liu 1 , Xiao-Ju Jin 1 , Fan Yang 1 , Fang Xu 1 , Wan-Di Qian 1 , Wen-Jun Guo 1
Affiliation  

The anatomical dimensions of the lumbar dural sac determine the sensory block level of spinal anesthesia; however, whether they show the same predictive value during continuous epidural anesthesia (CEA) remains undetermined. We designed the present study to verify the efficacy of the anatomical dimensions of the lumbar dural sac in predicting the sensory block level during labor analgesia. A total of 122 parturients with singleton pregnancies requesting labor analgesia were included in this study. The lumbar dural sac diameter (DSD), lumbar dural sac length (DSL), lumbar dural sac surface area (DSA), and lumbar dural sac volume (DSV) were measured with an ultrasound color Doppler diagnostic apparatus. CEA was performed at the L2-L3 interspace. After epidural cannulation, an electronic infusion pump containing 0.08% ropivacaine and sufentanil 0.4 μg/ml was connected. The sensory block level was determined with alcohol-soaked cotton, a cotton swab, and a pinprick. The analgesic efficacy of CEA was determined with a visual analog scale (VAS). The parturients were divided into two groups, “ideal analgesia” and “nonideal analgesia,” and the groups were compared by t test. Pearson’s correlation was performed to evaluate the association between the anatomical dimensions of the lumbar dural sac and sensory block level. Multiple linear regression analysis was used to create a model for predicting the sensory block level. In the ideal analgesia group, the height, DSL, DSA, DSV and DSD were significantly smaller, and the body mass index (BMI) was significantly larger (P < 0.05). In addition, the DSL demonstrated the strongest correlation with the peak level of pain block (r = − 0.816, P < 0.0001; Fig. 2A), temperature block (r = − 0.874, P < 0.0001; Fig. 3A) and tactile block (r = − 0.727, P < 0.0001; Fig. 4A). Finally, the multiple linear regression analysis revealed that DSL and BMI contributed to predicting the peak sensory block level. In conclusion, our study shows that the sensory block level of CEA is higher when the DSL, DSA, DSV and DSD of puerperae are lower. DSL and BMI can be treated as predictors of the peak sensory block level in CEA during labor analgesia.

中文翻译:

腰椎硬膜囊的解剖尺寸预测分娩期间连续硬膜外镇痛的感觉阻滞水平

腰硬膜囊的解剖尺寸决定了腰麻的感觉阻滞水平;然而,它们在连续硬膜外麻醉 (CEA) 期间是否显示出相同的预测值仍未确定。我们设计了本研究来验证腰椎硬膜囊的解剖尺寸在预测分娩镇痛期间感觉阻滞水平的有效性。本研究共纳入了 122 名要求分娩镇痛的单胎妊娠产妇。使用超声彩色多普勒诊断仪测量腰椎硬膜囊直径(DSD)、腰椎硬膜囊长度(DSL)、腰椎硬膜囊表面积(DSA)和腰椎硬膜囊体积(DSV)。CEA 在 L2-L3 间隙进行。硬膜外插管后,使用含有 0.08% 罗哌卡因和舒芬太尼 0 的电子输液泵。连接 4 μg/ml。用酒精浸泡的棉花、棉签和针刺测定感觉阻滞水平。CEA 的镇痛效果用视觉模拟量表 (VAS) 确定。将产妇分为“理想镇痛”和“非理想镇痛”两组,组间比较采用t检验。进行 Pearson 相关性以评估腰椎硬膜囊的解剖尺寸与感觉阻滞水平之间的关联。多元线性回归分析用于创建预测感觉阻滞水平的模型。理想镇痛组身高、DSL、DSA、DSV、DSD显着减小,体重指数(BMI)显着增大(P < 0.05)。此外,DSL 与疼痛阻滞的峰值水平相关性最强(r = - 0.816,P < 0. 0001; 图 2A)、温度块(r = - 0.874,P < 0.0001;图 3A)和触觉块(r = - 0.727,P < 0.0001;图 4A)。最后,多元线性回归分析表明,DSL 和 BMI 有助于预测峰值感觉阻滞水平。总之,我们的研究表明,当产妇的DSL、DSA、DSV和DSD较低时,CEA的感觉阻滞水平较高。DSL 和 BMI 可被视为分娩镇痛期间 CEA 感觉阻滞峰值水平的预测因子。产妇的DSV和DSD较低。DSL 和 BMI 可被视为分娩镇痛期间 CEA 感觉阻滞峰值水平的预测因子。产妇的DSV和DSD较低。DSL 和 BMI 可被视为分娩镇痛期间 CEA 感觉阻滞峰值水平的预测因子。
更新日期:2021-11-04
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