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Sonographic estimation of needle depth for cervical epidural blocks.

Authors
 Soo Hwan Kim  ;  Kang Hun Lee  ;  Kyung Bong Yoon  ;  Woo Young Park  ;  Duck-Mi Yoon 
Citation
 ANESTHESIA AND ANALGESIA, Vol.106(5) : 1542-1547, 2008 
Journal Title
 ANESTHESIA AND ANALGESIA 
ISSN
 0003-2999 
Issue Date
2008
MeSH
Adult ; Aged ; Aged, 80 and over ; Analgesia, Epidural*/adverse effects ; Cervical Vertebrae/diagnostic imaging* ; Dura Mater/diagnostic imaging ; Epidural Space/diagnostic imaging ; Female ; Humans ; Injections, Epidural*/adverse effects ; Ligamentum Flavum/diagnostic imaging ; Male ; Middle Aged ; Nerve Block/adverse effects ; Nerve Block/methods* ; Ultrasonography
Keywords
Adult ; Aged ; Aged, 80 and over ; Analgesia, Epidural*/adverse effects ; Cervical Vertebrae/diagnostic imaging* ; Dura Mater/diagnostic imaging ; Epidural Space/diagnostic imaging ; Female ; Humans ; Injections, Epidural*/adverse effects ; Ligamentum Flavum/diagnostic imaging ; Male ; Middle Aged ; Nerve Block/adverse effects ; Nerve Block/methods* ; Ultrasonography
Abstract
BACKGROUND: Cervical epidural steroid injections are often used to treat acute and chronic pain syndromes involving the face, neck, and upper extremities. Ultrasound has evolved as a valuable tool for performing neuraxial blocks, providing useful prepuncture information on the structure. Our goal was to evaluate the accuracy and precision of ultrasound by comparing skin to dura distance from ultrasound with the actual skin to epidural depth. METHODS: We enrolled 50 patients undergoing cervical epidural blocks at the pain clinic. Ultrasound images with transverse and longitudinal median views of the C6/7 area were taken. The epidural needle was inserted, reproducing the direction of the ultrasound beam on the longitudinal median view. Measured distances from skin to dura on each ultrasound view were compared with the actual needle depth. Additionally, we examined ultrasound visibility, the number of puncture attempts, and any complications related to the procedure. RESULTS: Concordance correlation coefficients between the measured distances on ultrasound and actual needle depth were 0.9272 and 0.9268 on transverse and longitudinal median view, respectively. The cervical epidural block was successfully performed on 48 patients (96%). There were two incidents (4%) of dural puncture. No bloody taps, postprocedure complications, or hemodynamic instability related to cervical epidural blocks occurred. CONCLUSIONS: Ultrasound provides very accurate information on the skin to dura distance for epidural blocks in the cervical spine. Knowledge of skin to dura distance and a preview of spinal anatomy before puncture can more safely identify the epidural space
Full Text
http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&AN=00000539-200805000-00035&LSLINK=80&D=ovft
DOI
10.1213/ane.0b013e318168b6a8
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Anesthesiology and Pain Medicine (마취통증의학교실) > 1. Journal Papers
Yonsei Authors
Yoon, Kyoung Bong(윤경봉) ORCID logo https://orcid.org/0000-0002-4167-1375
Yoon, Duck Mi(윤덕미)
Lee, Kang Hun(이강훈)
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/106339
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