Key result
CT-derived epidural depth strongly correlates with actual needle insertion depth within ~0.26 cm.
Why the study?
Does CT-derived depth prediction correlate with actual depth of needle insertion during thoracic epidural insertion?
Observational (n=29)
Does CT-derived depth prediction correlate with actual depth of needle insertion during thoracic epidural insertion?
Pre-operative chest CT scans can accurately predict the depth of the epidural space for thoracic epidural insertion, though it tends to overestimate the actual depth slightly.
May inform needle selection using existing CTs for thoracic epidurals; leaves open effects on success or safety in prospective trials.
In this single group observational study on 29 patients, we describe a technique that predicts the depth of the epidural space, calculated from the routine pre-operative chest computerised tomography (CT) scan using Pythagorean triangle trigonometry. We also compared the CT-derived depth of the epidural space with the actual depth of needle insertion. The CT-derived and the actual depths of the epidural space were highly correlated (r = 0.88, R2 = 0.78, p < 0.0001). The mean (95% CI) difference between CT-derived and actual depths was 0.26 (0.03-0.49) cm. Thus, the CT-derived depth tends to be greater than the actual depth by between 0.03 and 0.49 cm. There were no associations between either the CT-derived or the actual depth of the epidural space and age, weight, height or body mass index.
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Carnie et al. (2002) conducted an observational in Patients undergoing thoracic epidural insertion (n=29). CT-derived depth of the epidural space vs. Actual depth of needle insertion was evaluated on Difference between CT-derived and actual depths of the epidural space (MD 0.26 cm, 95% CI 0.03-0.49, p=<0.0001). CT-derived depth of the epidural space was highly correlated with actual needle insertion depth (r=0.88, p<0.0001), with a mean difference of 0.26 cm (95% CI 0.03-0.49).
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