Acoustic puncture assist device versus loss of resistance technique for epidural space identification
Autor: | Itee Chowdhury, Shagun Bhatia Shah, Nitesh Goel, Amit Kumar Mittal, Brijesh Pratap Singh, Pradeep Jakhar |
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Jazyk: | angličtina |
Rok vydání: | 2016 |
Předmět: |
medicine.medical_specialty
030204 cardiovascular system & hematology lcsh:RD78.3-87.3 03 medical and health sciences 0302 clinical medicine Lumbar epidural space localization 0502 economics and business Medicine Loss of resistance business.industry 05 social sciences Limits of agreement Ultrasound Confidence interval Epidural space Surgery Anesthesiology and Pain Medicine medicine.anatomical_structure Concordance correlation coefficient lcsh:Anesthesiology Acoustic puncture assist device sonography of epidural space 050211 marketing Original Article business Catheter placement Nuclear medicine |
Zdroj: | Indian Journal of Anaesthesia Indian Journal of Anaesthesia, Vol 60, Iss 5, Pp 330-336 (2016) |
ISSN: | 0976-2817 0019-5049 |
Popis: | Background and Aims: The conventional techniques of epidural space (EDS) identification based on loss of resistance (LOR) have a higher chance of complications, patchy analgesia and epidural failure, which can be minimised by objective confirmation of space before catheter placement. Acoustic puncture assist device (APAD) technique objectively confirms EDS, thus enhancing success, with lesser complications. This study was planned with the objective to evaluate the APAD technique and compare it to LOR technique for EDS identification and its correlation with ultrasound guided EDS depth. Methods: In this prospective study, the lumbar vertebral spaces were scanned by the ultrasound for measuring depth of the EDS and later correlated with procedural depth measured by either of the technique (APAD or LOR). The data were subjected to descriptive statistics; the concordance correlation coefficient and Bland-Altman analysis with 95% confidence limits. Results: Acoustic dip in pitch and descent in pressure tracing on EDS localisation was observed among the patients of APAD group. Analysis of concordance correlation between the ultrasonography (USG) depth and APAD or LOR depth was significant (r ≥ 0.97 in both groups). Bland-Altman analysis revealed a mean difference of 0.171cm in group APAD and 0.154 cm in group LOR. The 95% limits of agreement for the difference between the two measurements were − 0.569 and 0.226 cm in APAD and − 0.530 to 0.222 cm in LOR group. Conclusion: We found APAD to be a precise tool for objective localisation of the EDS, co-relating well with the pre-procedural USG depth of EDS. |
Databáze: | OpenAIRE |
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