Suitable depth of epidural puncture in nulliparous pregnant woman.

Abstract

We study the suitable depth for epidural puncture in primiparas so as to decrease epidural complications and provide anesthesiologists with an appropriate insertion guide. A prospective study of 87 primipara patients receiving labor analgesia who had epidural punctures in the course of vaginal delivery were randomly divided into 3 groups: the L 3,4 group (N = 27), the L 2,3 group (N = 29), and the L 1,2 group (N = 26). Predictive statistical models were used for the formulation of the ideal epidural puncture needle depth. Eighty two patients who had non-traumatic epidural punctures were studied. There were no significant changes in age, weight, height, weight/height ratio, gestational weeks, fetus weight, pregnancy weight, weight difference, and fetus weight (P > 0.05). Compared with L 3,4 intervertebral space, the puncture depth in L 1,2 and L 2,3 was significantly shorter (P < 0.05) and (P < 0.001), respectively; Regression equation: PD (cm) = 0.351 [LHZ] + 0.147 [BMI] + 0.017. The correlation coefficient for LHZ was 0.351 (95 % CI 0.278-0.424; P < 0.001), the correlation coefficient for BMI was 0.147 (95 % CI 0.123-0.171; P < 0.001). This formula is accurate and practical with less complex calculations. However, further validation through a prospective study will be required. It is an accurate way to localize the puncture site in parturients and improve the efficiency of puncture in parturients for analgesia labor.Epidural puncture depth prediction in L 1,2, L 2,3, and L 3,4 can supply with a related reference.