Intercristal Line, Posterior Superior Iliac Spine, Spinal Anesthesia, Ultrasonography
Conditions
Keywords
cesarean section, ultrasonography, spinal anesthesia, Posterior Superior Iliac Spine, intercristal line
Brief summary
Intercristal line as palpation landmarks to identifying the vertebral level is frequently inaccurate.To find more safe and reliable body surface markers and convenient methods to be solved in clinical work.The investigators performed a two-stage study to evaluated the accuracy of intercristal line and the The Posterior Superior Iliac Spine (PSIS) line to identify the lumbar interspinous spaces for spinal anesthesia using ultrasonography in pregnant woman which will provide a second option.
Detailed description
The investigators performed a two-stage study to evaluated the accuracy of Intercristal line and the PSIS line to identify the lumbar intervertebral space for spinal anesthesia using ultrasonography in pregnant woman. In phase 1, the distances between the PSIS line and each lumbar interspinous space is measured by ultrasound,and the mean and 95% confidence interval of distances in pregnant women with different height ranges were calculated to provide a reference for identifying specific lumbar spaces.In phase 2, a further 230 participants were received the PSIS, Intercristal line or both as palpation landmarks to define specific lumbar spaces.
Interventions
None listed
Sponsors
The Third Affiliated Hospital of Guangzhou Medical University
Study design
Observational model
CASE_CONTROL
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
FEMALE
Healthy volunteers
No
Inclusion criteria
* After obtaining written informed consents,pregnant women at 37-42 weeks of gestation
Exclusion criteria
* BMI ≥ 40 kg/m² (to minimize palpation variability), History of lumbar surgery/deformity (scoliosis, spondylolisthesis or osteoporotic vertebral collapse), Inability to maintain the flexed lateral decubitus position, Participant withdrawal, Unforeseen anatomical anomalies discovered during screening.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| The distance between the PSIS line and each mid-interspinous space | three days | PSIS line was defined as an intercristal line drawn between the the final posterior superior iliac spine point.Use a ruler to measure the distance between the PSIS line and each midddle- interspinous space （L1/2 through L5/S1）and record. The mean of distances and 95% confidence interval are calculated. |
| The accuracy of the anatomic landmarks to determine the L3/4 interspinous space | three days | The L3-L4 intervertebral space was detected using intercristal line and the PSIS line in a random order by 2 experienced anesthesiologists. After determining the L3-L4 intervertebral space using each method alternately, horizontal skin marks were created with an erasable pen. Then, another experienced anesthesiologist for ultrasonographic examination assessed the intervertebral spaces.After identifying the sacrum, the investigator moved the probe in a cephalad direction, counted the intervertebral spaces and assessed the actual intervertebral spaces of the 2 skin marks. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| The distance between the palpated intercristal line and PSIS line | three days | palpated intercristal line line was identified and marked by bilateral palpation of the iliac crest summits. Subsequently, two reference points were defined: "point PSIS" (intersection of the PSIS line with the spinal midline) and "point PI" (intersection of the PI line with the spinal midline). We then calculated the following three distances: the "L3/4 distance" (from the L3/4 interspinous space midpoint to point PSIS), the "PI distance" (from point PI to point PSIS) The experienced anesthesiologist for ultrasonographic examination assessed the actual interspinous space of the intercristal line. |
| baseline data | three days | The age |
| Maternal height | three days | Maternal height |
Countries
China
Contacts
STUDY_DIRECTORSouping Wang, PhD
The Third Affiliated Hospital of Guangzhou Medical University
Outcome results
None listed