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Comparison of the acoustic windows for the thoracic paramedian epidural approach after shoulder rotation: The lateral decubitus versus the sitting position

Authors
 Hyo-Jin Byon  ;  Sung-Jun Hong  ;  Dae-Yu Kim  ;  Joo-Hyeon  ;  In-Gon Lee  ;  Dong-Ho Seo  ;  Gyoung-A. Heo  ;  Hyunzu Kim 
Citation
 ANAESTHESIA CRITICAL CARE & PAIN MEDICINE, Vol.38(1) : 53-56, 2019 
Journal Title
 ANAESTHESIA CRITICAL CARE & PAIN MEDICINE 
Issue Date
2019
Keywords
Lateral decubitus position ; Posterior longitudinal ligament ; Shoulder rotation ; Sitting position ; Spinal ultrasonography ; Thoracic epidural
Abstract
BACKGROUND: The aim of this study was to compare the mean lengths of the posterior longitudinal ligament (PLL) as the acoustic window during the thoracic paramedian epidural approach after shoulder rotation, while subjects were in the lateral decubitus or in the sitting position. METHODS: Thirty-two adult male volunteers were placed in the right decubitus position or sitting position on a horizontal operating table. To obtain an optimal ultrasound view for the PLL on the right side, thoracic spinal ultrasonography was performed at the T6/7 interspace using the paramedian oblique sagittal plane. PLL length was measured on the ultrasound image before and after right shoulder rotation. RESULTS: Before shoulder rotation, the difference in mean PLL length between the sitting (11.1±1.3mm) and lateral decubitus (10.7±1.2mm) positions was not statistically significant (P=0.05). Within-position, the before and after comparison revealed that after shoulder rotation, PLL length was significantly increased to 12.2±1.4mm (P<0.001) and 12.0±1.5mm (P<0.001) in the sitting and lateral decubitus positions, respectively. However, after shoulder rotation the between-position difference in mean PLL length was not statistically significant (P=0.50) CONCLUSIONS: Shoulder rotation did not result in a statistically significant difference in the dimension of the acoustic target window for paramedian thoracic epidural access in the sitting compared to the lateral decubitus position.
Full Text
https://www.sciencedirect.com/science/article/pii/S2352556817302692
DOI
10.1016/j.accpm.2018.02.017
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Anesthesiology and Pain Medicine (마취통증의학교실) > 1. Journal Papers
Yonsei Authors
Byon, Hyo Jin(변효진)
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/173360
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