Medición de la distancia de la piel al espacio epidural por ultrasonografía y su correlación interobservador
Por:
Carrillo-Esper R., Nava-López J.A., Galván-Talamantes Y., Muñoz-García A., Hernández-Arias J.J., Hernández-Ramírez O., Muleiro-De Loera M.I., Ruiz-Sandoval A.
Publicada:
1 ene 2016
Categoría:
Anesthesiology and Pain Medicine
Resumen:
Ultrasonography in neuraxial anesthesia is useful in the identification of anatomical structures and in the determination of the epidural and subarachnoid space depth, reducing the complications and increases the success of neuraxial blockade. In Mexican population have been not done studies that allow measure and determine the ultrasonographic features of the epidural space. Objective: Determine the depth of the epidural space by ultrasonography in healthy Mexican population and determine the interobserver correlation with the use of ultrasonography. Material and methods: An observational, descriptive, transversal, non-randomized, open, prospective study was conducted. Were studied 81 healthy volunteers and they was measured distance of the skin to epidural space in a oblique-paramedium sagital view, at the intervertebral space L2-L3 using a portable ultrasound. Observations were made by three different anesthesiologists to determine the interobserver correlation. Results: Of the 81 volunteers studied 63% (51) were men and 37% (30) women. The mean age was 21 years (SD ± 1). The mean weight was 67 kg (SD ± 9), the height of 1.67 m (SD ± 0.08), body mass index of 24 (SD ± 2), waist circumference of 79 cm (SD ± 8). The mean distance from the skin to epidural space for the first observer was 4.77 cm (SD ± 0.56), for the second observer was 4.57 cm (SD ± 0.55), for the third observer was 4.79 cm (SD ± 0.56) and finally the mean average of the three measurements was 4.71 cm (SD ± 0.46). The kappa correlation index for observer 1 versus observer 2 was 0.20 with a p < 0.05. The correlation between observer 1 versus 3 was of 0.20 (p < 0.05). Correlation between observer 2 versus 3 was not statistically significant. Conclusion: Ultrasound is a useful tool for determining the depth of the epidural space. A minimum of training per week with ultrasound is required to have a good clinical correlation. © 2016, Colegio Mexicano de Anestesiologia A.C. All rights reserved.
Filiaciones:
Carrillo-Esper R.:
Academia Nacional de Medicina, Academia Mexicana de Cirugía, Mexico
Nava-López J.A.:
Hospital General de México «Eduardo Liceaga», Instituto Nacional De Rehabilitación, Mexico
Galván-Talamantes Y.:
Instituto Nacional Ciencias Médicas y de la Nutrición «Salvador Zubirán», Mexico
Muñoz-García A.:
Hospital «Dr. Manuel Gea González», Mexico
Hernández-Arias J.J.:
Hospital General de México «Dr. Eduardo Liceaga», Mexico
Hernández-Ramírez O.:
Hospital «Dr. Manuel Gea González», Mexico
Muleiro-De Loera M.I.:
Hospital General de Durango, Mexico
Ruiz-Sandoval A.:
Hospital General Naval de Alta Especialidad, Mexico
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