临床和实验室研究年鉴

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A Prospective Observational Study to Compare the Depth of Subarachnoid Space Using Anthropometric Measurements, Ultrasonographic Measurements and Actual Depth by Needle Insertion

Vasundhera Tyagi, Vatsal Jain, Bhanupriya Agrawal, Manish Jain, Bhawna Rastogi and Ritesh Srivastava

Introduction: A pre puncture estimation of subarachnoid space depth using ultrasound may guide spinal needle placement and help to reduce failure rate and complication associated with lumber puncture. Our aim of study was to determine SSD using anthropometric, ultrasonographic and actual depth by needle insertion and to compare them.

Materials and methods: A total of 120 patients who got admitted to Subharti Hospital for elective infraumbilical surgery under spinal anaesthesia from July 2016 to June 2018 were included in our study. Preoperative assessment of SSD using anthropometric by Bonodio’s formula and ultrasonography was done and intraoperative actual depth was measured after needle insertion.

Results: Mean subarachnoid space depth by Bonadio formula, USG and actual depth in male was 5.12 ± 0.3, 4.27 ± 0.55 and 4.28 ± 0.57 respectively while in female it was 5.17 ± 0.3, 4.14 ± 0.60, 4.17 ± 0.5 respectively.

Conclusion: Subarachnoid space depth using Bonodio’s formula did not correlate with the depth measured by ultrasound or actual needle insertion but the measurements with ultrasound and actual needle insertion showed significant correlation which proves that Bonodio’s formula did not predict the correct value of subarachnoid space in comparison to ultrasound measurement. Therefore, ultrasound makes it possible to have an accurate estimation of the depth to reach intrathecal space and can help to reduce the no of attempts of needle insertion and also to reduce the failure and complication rates.