Dry spinal tap during real-time ultrasound-guided paramedian spinal injection with patient in the lateral decubitus position: A single-centre retrospective study
| Autor: | Ranjith Kumar Sivakumar, Pornpatra Areeruk, Sunena Somani, Louis Y H Mok, Winnie Samy, Manoj K. Karmakar |
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| Rok vydání: | 2020 |
| Předmět: |
Spinal tap
China Neuraxial blockade Anesthesia Spinal Spinal Puncture 03 medical and health sciences 0302 clinical medicine Cerebrospinal fluid 030202 anesthesiology Lateral Decubitus Position Medicine Humans Injections Spinal Ultrasonography Interventional Aged Retrospective Studies Aged 80 and over business.industry Ultrasound 030208 emergency & critical care medicine Retrospective cohort study Middle Aged film.actor Anesthesiology and Pain Medicine film Anesthesia Thecal sac business |
| Zdroj: | European journal of anaesthesiology. 38(3) |
| ISSN: | 1365-2346 |
| Popis: | Background Real-time ultrasound-guided (USG) spinal injection is generally performed via the paramedian sagittal oblique (PMSO) ultrasound window. Objective The aim of this retrospective study was to draw attention to the occurrence of 'dry tap' during real-time USG spinal injection. Design Single-centre retrospective study. Setting University teaching hospital, Hong Kong, China. Patients Data from 113 patients (aged 69.2 ± 18.0 years and BMI 22.3 ± 3.6 kg m-2) of American Society of Anesthesiologists physical status 1 to 3 scheduled for surgery under neuraxial blockade between 2007 to 2017 were reviewed. Interventions Real-time USG spinal injections or combined spinal-epidural (CSE) using the PMSO ultrasound window with the patient in the lateral decubitus position and the spinal needle inserted from the nondependent side were studied. Main outcome measures 'Dry tap' was defined as a failure of cerebrospinal fluid (CSF) to efflux from the hub of the needle, within 3 min, with the spinal needle visualised sonographically within the thecal sac. 'Slow CSF efflux' was defined as efflux of CSF within 1 to 3 min. Irrespective of whether it was a 'dry tap' or 'slow CSF efflux', the planned dose of local anaesthetic was injected through the spinal needle. Results The combined incidence of 'dry tap' and 'slow CSF efflux' was 23.8% (27/113) with an individual incidence for each event of 9.7% (11/113) and 14.2% (16/113), respectively. Under the conditions of this study, successful spinal anaesthesia developed in all patients. Conclusion 'Dry tap' occurs in 9.7% of cases during real-time USG spinal injection using the PMSO ultrasound window, with the patient in the lateral decubitus position and the spinal needle inserted from the nondependent side. Trial registration ChiCTR-IOR-1800019011, Chinese Clinical Trials Registry (www.chictr.org.cn). |
| Databáze: | OpenAIRE |
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