当前位置： SCI文献检索 > ANESTHESIA AND ANALGESIA期刊下所有文献 > Three-dimensional computed tomography for difficult thoracic epidural needle placement.

Three-dimensional computed tomography for difficult thoracic epidural needle placement.

Abstract：

BACKGROUND:Thoracic epidural anesthesia is often used as a postoperative analgesic technique in thoracic surgery. However, the structure of the overlapping spinous processes, resulting in interlaminar space occlusion, often makes thoracic epidural needle placement difficult. With the development of multi-detector row spiral computed tomography (CT), three-dimensional (3D) thoracic images can be readily obtained, providing potentially useful clinical information. Therefore, we conducted this study to evaluate the correlation between difficult thoracic epidural needle placement and anatomical findings obtained by 3DCT image processing techniques. METHODS:Seventy-eight patients were studied. The number of new skin puncture attempts required for successful catheter insertion into the epidural space and the time spent during the procedure were recorded for each patient. The patients were defined as a first-level success when the needle placement was successful at the spinal level initially attempted. The others were defined as a first-level failure. The number of occluded mid-thoracic interlaminar spaces and the existence of mid-thoracic supraspinous and interspinous ligament ossification on the 3DCT images were also evaluated. RESULTS:The percentage of first-level success was 84.6%. The number of occluded mid-thoracic interlaminar spaces was significantly greater in the first-level failure than in the first-level success (P < 0.001). The incidence of ossification of the mid-thoracic supraspinous ligament was significantly more frequent in first-level failure than in the first-level success (P = 0.001). The number of attempts and the time spent during the procedure significantly correlated to the number of occluded mid-thoracic interlaminar spaces (P < 0.001). CONCLUSION:Preoperative 3DCT imaging may be useful in predicting difficult thoracic epidural needle placement.

journal_name

Anesth Analg

journal_title

Anesthesia and analgesia

authors

Murata H,Sakai T,Goto S,Sumikawa K

doi

10.1213/ane.0b013e31815efa06

subject

Has Abstract

pub_date

2008-02-01 00:00:00

pages

654-8, table of contents

issue

eissn

0003-2999

issn

1526-7598

pii

106/2/654

journal_volume

106

pub_type

杂志文章

在线工具

Three-dimensional computed tomography for difficult thoracic epidural needle placement.