Abdominal girth and vertebral column length can adjust spinal anesthesia for lower limb surgery, a prospective, observational study.

Qing-He Zhou,Bo Zhu,Min Yan,Chang-Na Wei

doi:10.1186/s12871-016-0184-3

Qing-He Zhou, Bo Zhu + Show 2 more

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https://doi.org/10.1186/s12871-016-0184-3

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Abstract

BackgroundStudies have shown that abdominal girth and vertebral column length have high predictive value for spinal spread after administering a dose of plain bupivacaine. we designed a study to identify the specific correlations between abdominal girth, vertebral column length and a 0.5 % dosage of plain bupivacaine, which should provide a minimum upper block level (T12) and a suitable upper block level (T10) for lower limb surgeries.MethodsA suitable dose of 0.5 % plain bupivacaine was administered intrathecally between the L3 and L4 vertebrae for lower limb surgeries. If the upper cephalad spread of the patient by loss of pinprick discrimination was T12 or T10, the patient was enrolled in this study. Five patient variables and intrathecal plain bupivacaine dose were recorded. Linear regression and multiple regression analyses were performed.ResultsTotals of 111 patients and 121 patients who lost pinprick discrimination at T12 and T10, respectively, were analyzed in this study. Linear regression analysis showed that only abdominal girth and plain bupivacaine dose were strongly correlated (r =−0.827 for T12, r = −0.806 for T10; both p < 0.0001). Multiple linear regression analysis showed that both abdominal girth and vertebral column length were the key determinants of plain bupivacaine dose (both p < 0.0001). R2 was 0.874 and 0.860 for the loss of pinprick discrimination at T12 and T10, respectively.ConclusionsOur data indicated that vertebral column length and abdominal girth were strongly correlated with the dosage of intrathecal plain bupivacaine for the loss of pinprick discrimination at T12 and T10. The two regression equations were YT12 = 3.547 + 0.045X1-0.044X2 and YT10 = 3.848 + 0.047X1- 0.046X2 (Y, 0.5 % plain bupivacaine volume; X1, vertebral column length;and X 2, abdominal girth), which can accurately predict the minimum and suitable intrathecal bupivacaine dose for lower limb surgery to a great extent, separately.

Highlights

Studies have shown that abdominal girth and vertebral column length have high predictive value for spinal spread after administering a dose of plain bupivacaine. we designed a study to identify the specific correlations between abdominal girth, vertebral column length and a 0.5 % dosage of plain bupivacaine, which should provide a minimum upper block level (T12) and a suitable upper block level (T10) for lower limb surgeries
We designed a prospective, observational study to identify the specific correlations between abdominal girth, vertebral column length and a 0.5 % dosage of plain bupivacaine, which should provide a minimum upper block level (T12) and a suitable upper block level (T10) for lower limb surgeries
If the ultimate spinal anesthesia level of loss of pinprick discrimination in both midclavicular lines was T12 or T10 in 60 min after the intrathecal injection, the patient was picked out to analyze in our study, and the vertebral column length was measured from the C7 vertebra to the sacral hiatus, with the patient placed supine on the operation table

Summary

Introduction

Studies have shown that abdominal girth and vertebral column length have high predictive value for spinal spread after administering a dose of plain bupivacaine. we designed a study to identify the specific correlations between abdominal girth, vertebral column length and a 0.5 % dosage of plain bupivacaine, which should provide a minimum upper block level (T12) and a suitable upper block level (T10) for lower limb surgeries. Studies have shown that abdominal girth and vertebral column length have high predictive value for spinal spread after administering a dose of plain bupivacaine. We designed a study to identify the specific correlations between abdominal girth, vertebral column length and a 0.5 % dosage of plain bupivacaine, which should provide a minimum upper block level (T12) and a suitable upper block level (T10) for lower limb surgeries. Lumbosacral cerebrospinal fluid volume was found to be the primary determinant that affect spinal cephalad spread [10], Our previous study showed that abdominal girth and vertebral column length were highly predictive of the. We designed a prospective, observational study to identify the specific correlations between abdominal girth, vertebral column length and a 0.5 % dosage of plain bupivacaine, which should provide a minimum upper block level (T12) and a suitable upper block level (T10) for lower limb surgeries

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