Research Article
Ultrasonographic Estimation of Skin to Subarachnoid Space Depth in the Pre-eclamptic Indian Parturients and its Comparison with Physical Index Based Formula− A Prospective Observational Study
Sutagatti JG1*, Kurdi MS2 and Bilung PA2
1Department of Radiodiagnosis, Karnataka Institute of Medical Sciences, Hubli, Karnataka, India
2Department of Anesthesiology, Karnataka Institute of Medical Sciences, Hubli, Karnataka, India
*Corresponding author: Sutagatti JG, Department of Radiodiagnosis, Karnataka Institute of Medical Sciences,
Hubli, Karnataka, India, Tel: +919448054113; E-mail: drjagadishsutagatti@yahoo.com
Copyright: © 2019 Sutagatti JG, et al. This is an open access article distributed under the Creative Commons Attribution
License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is
properly cited.
Article Information: Submission: 04/06/2019; Accepted: 19/07/2019; Published: 22/07/2019
Abstract
Introduction: Spinal Anesthesia technique can be difficult to perform in parturients with pre-eclampsia (PE) due to weight gain along with edema
obscuring the anatomical landmarks.
Aim: This study was planned to determine the skin to subarachnoid space depth (SSD) in full term parturients with PE by ultrasonography (USG) &
physical index based method using Stocker’s formula. The primary outcome was to find out which method correlates best with clinically measured SSD in the
study population. The secondary outcome was to find the difference in SSD between patients with mild PE and those with severe PE.
Materials and Methods: A randomized prospective study for a period of one year was conducted on 100 PE parturients (power of study 95%) aged above
18 years of American Society of Anesthesiologist(ASA) physical status II and III undergoing elective lower segment caesarian section. Pre-procedural USG
of lumbar spine at L3-4 level was done. SSD was noted and marked with a surgical skin marker. Later, on the operation table (OT) SSD was measured with
Quincke spinal needle through the skin marking using conventional landmark technique. These values were then compared with physical index based formula.
Data analysis was done using Microsoft excel and analysed by Statistical Package for the Social Sciences (SPSS) 17.0 version.
Results: Data was collected & analyzed on remaining 97 cases. Bland Altman analysis showed that the limits between SSD-USG & SSD-OT were
narrower (-0.70 to 0.09) than that of SSD-Stockers & SSD-OT (-0.11 to 1.94) which were wider with a larger difference. The SSD-OT in mild PE (4.6 ± 0.5 cm)
& SSD-US (4.3 ± 0.5 cm) was less compared to SSD-OT in severe PE (5.2 ± 0.4 cm) & SSD-US (4.9 ± 0.4 cm).
Conclusion: Pre-procedural USG can be useful in estimating the SSD in parturients with PE who have back edema.