None listed
Conditions
Brief summary
combined spinal epidural anesthesia is frequently used for inguinal hernia repair in our institution. Conventional palpation method has widely been used to locate the intervertebral space resulting in some complications. with the developments in technology and widespread use of ultrasound, precise navigation of intervertebral space is easier with almost exact results. ultrasound guides the anesthesiologist to navigate the desired intervertebral space to introduce the epidural needle, gives provision of the precise angle and predicts the depth of epidural space where epidural needle can be introduced safely. this results in reduced complications and increased patient safety. We could not find any data in the literature comparing the correlation of ultrasonographic measurements of epidural depth at saggital paramedian oblique plane and transverse plane with the actual epidural depth. The aim of the current study is to measure the epidural depth with ultrasound at saggital paramedian oblique plane and transverse plane in patients undergoing inguinal hernia repair under combined spinal epidural anesthesia and determine the correlations of these measurements with the actual epidural depth.
Interventions
The measurements will be done at the operation room after monitorization of the patient in accordance with the standards of American Society of Anesthesiologists. An anesthesiologist experienced in sonoanatomy will do the ultrasonographic examination of epidural space in both transverse and saggital paramedian oblique plane. The depth of epidural space in both examinations will be recorded. While performing combined spinal epidural anesthesia, after aseptic preparing the skin and infiltration of
The measurements will be done at the operation room after monitorization of the patient in accordance with the standards of American Society of Anesthesiologists. An anesthesiologist experienced in sonoanatomy will do the ultrasonographic examination of epidural space in both transverse and saggital paramedian oblique plane. The depth of epidural space in both examinations will be recorded. While performing combined spinal epidural anesthesia, after aseptic preparing the skin and infiltration of entry site for epidural needle with local anesthetic drug, epidural needle will be introduced from skin through epidural space with loss of resistance technique. at the point epidural space is reached, epidural needle will be marked with a sterile permenant marker and after introducing spinal needle through epidural needle, free flow of cerebrospinal fluid will be observed, spinal needle will be locked within the epidural needle and 3ml 0.5% hyperbaric bupivacaine will be injected. The distance between the tip of epidural needle and the spinal needle will be measured. The actual depth of epidural space will be measured as the distance marked on the epidural needle to its tip. the depth of subarachnoid space will be accepted as the distance between the tip of spinal needle and the tip of epidural needle plus the measured actual epidural depth which was formerly defined.
Sponsors
mehmet cantürk
Eligibility
Sex/Gender
All
Age
18 Years to 80 Years
Healthy volunteers
No
Inclusion criteria
patients scheduled for elective inguinal hernia repair with combined spinal epidural anesthesia aged between 18-80 years, with american society of anesthesiologists physical risk score<IV
Exclusion criteria
American society of anesthesiologists physical risk score >3, any contraindication for spinal anesthesia, coagulopathy and/or anticoagulant drug use , patient refusal to participate to study, and emergency cases.
Outcome results
None listed