Anatomical dimensions of the lumbar dural sac predict the sensory block level of continuous epidural analgesia during labor

Abstract Background 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...

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Autores principales:	Chen-yang Xu, Can Liu, Xiao-ju Jin, Fan Yang, Fang Xu, Wan-Di Qian, Wen-jun Guo
Formato:	article
Lenguaje:	EN
Publicado:	BMC 2021
Materias:	Dural sac Ultrasound Labor analgesia Continuous epidural anesthesia Anesthesiology RD78.3-87.3
Acceso en línea:	https://doaj.org/article/c48e9d43af8444fbbe64a76ec88b6a92
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spelling	oai:doaj.org-article:c48e9d43af8444fbbe64a76ec88b6a922021-11-07T12:18:18ZAnatomical dimensions of the lumbar dural sac predict the sensory block level of continuous epidural analgesia during labor10.1186/s12871-021-01485-51471-2253https://doaj.org/article/c48e9d43af8444fbbe64a76ec88b6a922021-11-01T00:00:00Zhttps://doi.org/10.1186/s12871-021-01485-5https://doaj.org/toc/1471-2253Abstract Background 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. Methods 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. Results 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. Conclusion 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.Chen-yang XuCan LiuXiao-ju JinFan YangFang XuWan-Di QianWen-jun GuoBMCarticleDural sacUltrasoundLabor analgesiaContinuous epidural anesthesiaAnesthesiologyRD78.3-87.3ENBMC Anesthesiology, Vol 21, Iss 1, Pp 1-9 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Dural sac Ultrasound Labor analgesia Continuous epidural anesthesia Anesthesiology RD78.3-87.3
spellingShingle	Dural sac Ultrasound Labor analgesia Continuous epidural anesthesia Anesthesiology RD78.3-87.3 Chen-yang Xu Can Liu Xiao-ju Jin Fan Yang Fang Xu Wan-Di Qian Wen-jun Guo Anatomical dimensions of the lumbar dural sac predict the sensory block level of continuous epidural analgesia during labor
description	Abstract Background 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. Methods 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. Results 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. Conclusion 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.
format	article
author	Chen-yang Xu Can Liu Xiao-ju Jin Fan Yang Fang Xu Wan-Di Qian Wen-jun Guo
author_facet	Chen-yang Xu Can Liu Xiao-ju Jin Fan Yang Fang Xu Wan-Di Qian Wen-jun Guo
author_sort	Chen-yang Xu
title	Anatomical dimensions of the lumbar dural sac predict the sensory block level of continuous epidural analgesia during labor
title_short	Anatomical dimensions of the lumbar dural sac predict the sensory block level of continuous epidural analgesia during labor
title_full	Anatomical dimensions of the lumbar dural sac predict the sensory block level of continuous epidural analgesia during labor
title_fullStr	Anatomical dimensions of the lumbar dural sac predict the sensory block level of continuous epidural analgesia during labor
title_full_unstemmed	Anatomical dimensions of the lumbar dural sac predict the sensory block level of continuous epidural analgesia during labor
title_sort	anatomical dimensions of the lumbar dural sac predict the sensory block level of continuous epidural analgesia during labor
publisher	BMC
publishDate	2021
url	https://doaj.org/article/c48e9d43af8444fbbe64a76ec88b6a92
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Anatomical dimensions of the lumbar dural sac predict the sensory block level of continuous epidural analgesia during labor

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