Page 16 - 麻醉与监护论坛2016年第1期
P. 16
Cover Thesis
epidural anesthesia[1]. examination improves the success rate for combined
The 5-10 MHz linear probe scan depth is 7cm, the
spinal-epidural anesthesia especially in obese
ultrasound imaging technique is helpless if the depth
from skin to ligamentum flavum beyond 7cm. The parturients,and the incidences of complications
needle depth is longer than the ultrasound measured
depth in our study. Because of we must press the associated with anesthesia is lower. The ultrasound
probe to skin, it may shorten the measured depth.
The front of the needle may skewing during the imaging technique is a useful tool for clinic practice,
puncture, increased the needle length. It still help us
to evaluate the needle length pre-insertion. it can help the anesthetist.
The complications related to anesthesia References
procedure is lower in ultrasound group. We used
the ultrasound imaging to indentify the vascular [1] Li TF, Wang KJ, Wu JP. Ultrasonic measurement on lumbar
pulsation in epidural space, if it occurs we will dural sac diameter during pregnancy. The Journal of Clinical
change the intervertebral space to avoid hematoma. Anesthesiology 2010; 26(3): 234-5
The incidence of bleeding in epidural catheter is
lower than two other studies[2-3], it owed to the [2] Zhong C. Observation for hemorrhage rate in epidural
ultrasound imaging. The method to indentify the anesthesia cathetering during cesarean delivery for puerpera
puncture site with intersection, it can reduce the carrying or infected by HBV. Hebei Medical Journal 2011;
puncture attempts. Repeated puncture can injure the 33(13): 1962-3
supraspinous ligament and interspinous ligaments,
it may result in backache. The parturients should [3] Zhou RC. The influence of puncture tube in different lateral
activity early post-operation, it can reduce the edema position on epidural vascular injury for puerpera. Chinese
of the puncture site, the incidence of backache may General Practice 2009; 8: 677-8
be reduced. The incidence of backache was lower in
our study than the other study[4], it may owe to our [4] Du SF, Li YX, Li XR, et al. Clinical observation on the prevention
puncture method. and cure for back lumbago incurred by epidural anesthesia.
Journal of Modern Oncology 2004; 12(6): 554-5
Accompany the potable ultrasonic instrument was
increasingly used in many fields of anesthesia, we [5] Zuo YX, Liu J, Zhu T, et al. The application of bedside ultrasound
can recognize the ultrasound image of nerve, blood for anesthesia and critical disease. China Continuing Medical
vessel, et.al[5].There were many more anesthetists Education 2011; 10: 46-50
used the ultrasound for intraspinal anesthesia[6-11], it
may a newly method to indentify the intervertebral [6] Grau T, Leipold RW, Conradi R, et al. Efficacy of ultrasound
space. imaging in obstetric epidural anesthesia. Clin Anesth 2002;
14: 169-175
The limitation of our study is not grouping by
body mass index, it may affect the results. [7] Grau T, Leipold RW, Conradi R, et a1. Ultrasound imaging
facilitates localization of the epidural space during combined
In conclusion,pre-puncture ultrasound spinal and epidural anesthesia. Rag Anesth Pain Med 2001;
26: 64-67
[8] Arzola C, Davies S, Rofaeel A, et a1. Ultrasound using the
transverse approach to the lumbar spine provides reliable
landmarks for labor epidurals. AnesthAnalg 2007; 104: 1188-
92
[9] Balki M. Locating the epidural space in obstetric patients-
ultrasound a useful tool: continuing professional
development. Can J Anesth 2010; 57(12): 1111-26.
[10] Arzola C, Davies S, Rofaeel A, et al. Ultrasound using the
transverse approach to the lumbar spine provides reliable
landmarks for labor epidurals. AnesthAnalg 2007; 104(5):
1188-92
[11] Sahin T, Balaban O, Sahin L, et al. A randomized controlled trial
of pre-insertion ultrasound guidance for spinal anesthesia
in pregnancy: outcomes among obese and lean parturient:
Ultrasound for spinal anesthesia in pregnancy. Anesth
2013animal model? The Journal of urology. 2005; 173(3):
1033-8.
Laboratory and ClinicalCIonverstTighaetsioisn 23 FAM 2016 Jan/Feb Vol.23 Issue 1
123