Page 15 - 麻醉与监护论坛2016年第1期

Cover Thesis

For count data, the chi square test was used. The puncture success rate is higher, so it can reduce the
P value of 0.05 was considered to be statistically number of required insertion attempts. Preinsertion
significant. the anesthetist can estimate the epidural needle

Results Table1 Comparing the patients characteristics and obstetrics
Patients data are shown in Table 1. All patients data, the times, the measured depth, and the needle depth(t-
enrolled completed the study. No important test).
differences were noted in both groups with respect
to age, gestational weeks, weight, height, body Age(years) Group 1 Group 2 p
mass index(BMI), and needle depth(Table 1). In Gestational 26.84±3.15 27.22±4.36 1.2086
group 2, the ligamentum flavum was visible in all 0.6618
patients, and measured the depth from skin to weeks(day) 274.29±4.64 274.29±4.19 1.9999
ligamentum flavum. Compared the measured depth Weight(kg) 1.5797
and the needle length, there was no significant Height(cm) 70.62±8.38 67.08±3.15 1.9692
difference(Table 1). The time to locate the L3- BMI(kg m-2) 161.37±4.96 160.66±3.79
L4 space in group 2 was longer than that in group Measured 26.46±2.32 27.51±3.30 0.082
1(P<0.01), but the time that the anesthesia effect depth(cm) 0.0068
level to T8 after spinal anesthesia was no significant Needle length(cm) - 4.55±0.54 1.9659
difference(Table 1). The success rate of first attempt Locating times(s)
for combined spinal-epidural anesthesia in group 2 Time to T8 level 4.58±0.54 4.57±0.51
was higher than that of group 1(P<0.01), it means 20.27±5.12 372.31±53.26
the ultrasound imaging can help us to locate the 56.21±4.82 57.80±4.92
puncture site(Table 2). There was no post dural
puncture headache and motor abnormality in both Table2 Comparing the puncture times in both groups
groups. No significant differences were noted in
both groups with respect to sensory abnormalities, Number of puncture Group 1 Group 2 p
nerve irritation, post-operative backache in the third times 0.0078
and seventh day (Table 3). The number of bleeding 1 97(80.83%) 115(95.83%)
in epidural catheter and post-operative backache at 2 16(13.33%) 5(4.17)
the first day in group 1 was more than that of group 3 6(5.00%) 0
2(P<0.05). The total complications in group 1 was
higher than that in group 2(P<0.01) (Table 3). Single epidural 1(0.83) 0
anesthesia
Discussion
Table3 Comparing the complications related with anesthesia
Ultrasound imaging technique can help us in both groups(chi square test)
to pinpoint the L3-L4 space, through the single
puncture point inserted into the epidural needle, the Bleeding in epidural Group 1(yes) Group 2(yes) p
catheter 8(6.67%) 1(0.83%) 0.0174
6(5.00%) 3(2.50%) 0.3081
Nerve irritation 4(3.33%) 1(0.83%) 0.1752
Sensory abnormality
Postoperative 22(18.33%) 10(8.33%) 0.0227
7(5.83%) 2(1.67%) 0.0894
backache 1(0.83%)
1st day 0
3rd day
7th day

length needed from skin to ligamentum flavum, we
used the ultrasound imaging to measure the depth.
Repeated attempt increase the risk of injury, prolong
the puncture times, it may affect the patients
satisfaction.

The weight of pregnant women was markedly
increased throughout their third trimester, edema
was more frequent appeared, it was hard to indentify
the L3-L4 space used the landmark palpation.
In the third trimester of pregnant women, the
anteroposterior diameter of dural sac became
narrower, the volume of cerebrospinal fluid reduced,
it may affect the success rate for combined spinal-

Laboratory and ClinicalCInovveesrtTighaetsioisn 22 FAM 2016 Jan/Feb Vol.23 Issue 1
123