Real-time ultrasound-guided thoracic epidural placement: Illustrating the techniques and reporting on prospective observational study.

IF 1.2 Q3 SURGERY

Journal of perioperative practice Pub Date : 2025-01-17 DOI:10.1177/17504589241302221

Karuna Sutthibenjakul, Jatuporn Pakpirom, Sirikarn Siripruekpong, Somrutai Boonchuduang

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引用次数: 0

Abstract

Background: This study aimed to assess the feasibility of real-time ultrasound-guided thoracic epidural placement.

Methods: A prospective observational study was conducted in 20 patients undergoing elective abdominal and thoracic surgery. The procedure, performed with patients in a lateral position, involved three sequential steps: (1) identification of the interlaminar gap, (2) advancement of the Touhy needle, and (3) identification of the epidural space. Success was defined as the catheter insertion with achieving sensory blockade. The estimated and actual epidural depth, thoracic epidural placement success rate and procedural time were recorded.

Results: The average age and body mass index were 62.1 ± 8.9 years and 22.4 ± 4.4 kg/m². Thoracic epidural placement was successful in 18 patients (90%, 95% confidence interval: 77-100), and at first attempt in 12 of those (66.7%). The thoracic epidural placement times and total procedural time were 5 (4-6.75) min and 19.5 ± 5.4 min, respectively. The correlation between ultrasound-estimated epidural depth and actual depth was 0.81.

Conclusion: Ultrasound guidance enhances thoracic epidural success rates and reduces attempts and skin punctures.

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实时超声引导下的胸椎硬膜外置入：说明技术并报告前瞻性观察研究。

背景：本研究旨在评估实时超声引导下胸腔硬膜外放置的可行性。方法：对20例择期胸腹手术患者进行前瞻性观察研究。侧卧位患者的手术包括三个连续步骤：(1)识别椎板间隙，(2)推进Touhy针，(3)识别硬膜外间隙。成功定义为导管插入并实现感觉阻塞。记录预估及实际硬膜外深度、胸段硬膜外放置成功率及手术时间。结果：平均年龄为62.1±8.9岁，体重指数为22.4±4.4 kg/m2。18例患者（90%，95%可信区间：77-100）成功置入胸部硬膜外，其中12例首次置入成功（66.7%）。胸段硬膜外置管时间为5 (4-6.75)min，总手术时间为19.5±5.4 min。超声估计的硬膜外深度与实际深度的相关性为0.81。结论：超声引导可提高胸段硬膜外穿刺成功率，减少穿刺次数和皮肤穿刺次数。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of perioperative practice Nursing-Medical and Surgical Nursing

CiteScore

1.60

自引率

0.00%

发文量

期刊介绍： The Journal of Perioperative Practice (JPP) is the official journal of the Association for Perioperative Practice (AfPP). It is an international, peer reviewed journal with a multidisciplinary ethos across all aspects of perioperative care. The overall aim of the journal is to improve patient safety through informing and developing practice. It is an informative professional journal which provides current evidence-based practice, clinical, management and educational developments for practitioners working in the perioperative environment. The journal promotes perioperative practice by publishing clinical research-based articles, literature reviews, topical discussions, advice on clinical issues, current news items and product information.