Key result
Preoperative computed tomography epidural space depth positively correlated with the measured loss of resistance (R^2 = 0.5692, p < 0.0001), which was larger by a mean of 0.79 cm.
Why the study?
Does the use of computed tomography scans and patient demographics accurately estimate the depth of the thoracic epidural space compared to the loss of resistance technique in patients receiving a thoracic epidural catheter?
Observational (n=218)
Does the use of computed tomography scans and patient demographics accurately estimate the depth of the thoracic epidural space compared to the loss of resistance technique in patients receiving a thoracic epidural catheter?
Preoperative CT scans combined with patient demographics can provide a valuable estimation of thoracic epidural space depth, correlating positively with the actual loss of resistance depth.
May aid thoracic epidural depth prediction from CT and demographics; leaves open need for prospective validation before clinical adoption.
Background and Objectives. Previous studies have used varying methods to estimate the depth of the epidural space prior to placement of an epidural catheter. We aim to use computed tomography scans, patient demographics, and vertebral level to estimate the depth of the loss of resistance for placement of thoracic epidural catheters. Methods. The records of consecutive patients who received a thoracic epidural catheter were reviewed. Patient demographics, epidural placement site, and technique were collected. Preoperative computed tomography scans were reviewed to measure the skin to epidural space distance. Linear regression was used for a multivariate analysis. Results. The records of 218 patients were reviewed. The mean loss of resistance measurement was significantly larger than the mean computed tomography epidural space depth measurement by 0.79 cm (p < 0.001). Our final multivariate model, adjusted for demographic and epidural technique, showed a positive correlation between the loss of resistance and the computed tomography epidural space depth measurement (R (2) = 0.5692, p < 0.0001). Conclusions. The measured loss of resistance is positively correlated with the computed tomography epidural space depth measurement and patient demographics. For patients undergoing thoracic or abdominal surgery, estimating the loss of resistance can be a valuable tool.
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Kosturakis et al. (2015) conducted an observational in Patients receiving a thoracic epidural catheter (n=218). Preoperative computed tomography scans and patient demographics was evaluated on Difference between loss of resistance measurement and computed tomography epidural space depth measurement (Mean difference 0.79 cm, p=< 0.001). Preoperative computed tomography epidural space depth positively correlated with the measured loss of resistance (R^2 = 0.5692, p < 0.0001), which was larger by a mean of 0.79 cm.
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