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Cover Thesis
noninvasive blood pressure and electrocardiogram in Picture2 The longitudinal plane ultrasound imaging of the
the operating room. Using a sealed envelope method, L3-L4 space
parturients were randomly divided into two groups.
Group 1(n=120): we used the traditional landmark combined spinal-epidural anesthesia. Make sure
locating method to indentify the L3-L4 space. Group the epidural needle entre the epidural space with
2(n=120):we used the ultrasound imaging technology the physiological saline and bubble method, and
to indentify the L3-L4 space. record the length of the epidural needle. Then insert
the spinal needle into the subarachnoid space, if
The ultrasonography was performed by the same the cerebrospinal fluid backflow from the spinal
experienced ultrasound doctor. All the patients needle, 12mg 0.5% isobaric ropivacaine diluted by
should be adopted on the right side of lie, double leg cerebrospinal fluid was administered. If there isn’t
is inflectional, both hands hold the knees. In group cerebrospinal fluid in the spinal needle, we will repeat
1, we connect both the anterior superior spine, the the procedure. If failed three times, we will insert the
imaginary line has an intersection with the spine, epidural catheter into the epidural space, only use
the point of intersection is L3 or L3-L4 space. In the epidural anesthesia. Before the operation we test
group 2, we use the Sonosite Nerve Series ultrasonic the anesthesia level by alcohol cotton. Make sure the
instrument and 5-10 MHz L38xi linear array probe level at T8. The number of puncture attempts and the
to locate the L3-L4 space. The linear probe scan the number of the patients were recorded.
transverse plane from lunbosacral spine to L3-L4
space(Fig 1), finding the best image of the ultrasound At the same time, the age, weight, height, and the
and mark the midline of the probe, then we use the body mass index of the patients were recorded. We
L3 and L4 to locate the longitudinal plane of the L3-L4 record the number of bleeding in epidural catheter,
space(Fig 2) and mark the midline of the probe. We the number of nerve irritation when inserted the
connect the transverse and longitudinal marker, the epidural catheter or spinal needle, the number
point of intersection is the best puncture site of the of post dural puncture headache, the number of
L3-L4 space. Measured the depth from the skin to the post-operative lower extremity sensory or motor
ligamentum flavum and recorded the times to locate abnormalities, and the number of post-operative
backache at the first, third, seventh day.
Picture1 The transverse plane ultrasound imaging of the L3-
L4 space
the puncture site by an observer with a stopwatch. If Statistical analysis
we used the ultrasound imaging technique to locate
the L3-L4 space, should recognize the ultrasound Analyses were performed using the SAS 8.0 from
imaging of ligamentum flavum(LF) and post dura(PD). Department of Health Statistics, School of Medicine,
Shanghai Jiao Tong University. The t-test was used for
The same experienced anesthetist finished the comparison the measurement data in both groups.
Laboratory and ClinicalCIonverstTighaetsioisn 21 FAM 2016 Jan/Feb Vol.23 Issue 1
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