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PREDICTING MID-THORACIC EPIDURAL SPACE DEPTH USING BIOMETRIC PARAMETERS - A PRELIMINAR CASE STUDY
Author(s): ,
Castro, I.
Affiliations:
Instituto Português de Oncologia do Porto, Anesthesia and Intensive Care, Porto, Portugal
,
Pereira, D.
Affiliations:
Instituto Português de Oncologia do Porto, Anesthesia and Intensive Care, Porto, Portugal
,
Paulo, J.*
Affiliations:
Instituto Português de Oncologia do Porto, Anesthesia and Intensive Care, Porto, Portugal
,
Afonso, A.
Affiliations:
Instituto Português de Oncologia do Porto, Anesthesia and Intensive Care, Porto, Portugal
,
Correia, J.
Affiliations:
Instituto Português de Oncologia do Porto, Anesthesia and Intensive Care, Porto, Portugal
,
Ferreira, M.
Affiliations:
Instituto Português de Oncologia do Porto, Anesthesia and Intensive Care, Porto, Portugal
,
Silva, M.
Affiliations:
Instituto Português de Oncologia do Porto, Anesthesia and Intensive Care, Porto, Portugal
,
Castro, C.
Affiliations:
Instituto Português de Oncologia do Porto, Epidemiology, Porto, Portugal
,
Miranda, M.L.
Affiliations:
Instituto Português de Oncologia do Porto, Anesthesia and Intensive Care, Porto, Portugal
Sarmento, M.C.
Affiliations:
Instituto Português de Oncologia do Porto, Anesthesia and Intensive Care, Porto, Portugal
ESRA Academy. Paulo J. Sep 13, 2017; 190740; 212 Topic: REGIONAL ANAESTHESIA TECHNIQUES - BLOCK PERFORMANCE
Joana Paulo
Joana Paulo

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Abstract
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Background and Aims:

There are several tools (anthropometric formulas, ultrasound, CT scan, MRI) to estimate the depth of the thoracic epidural space. Despite having many fans, the regular use of imaging techniques is time & money consuming, requires a long learning curve by Anesthesiologists, and isn't always available preoperatively.

In another previous study presented as e-poster in ESRA 2014, we found a statistically significant relationship between weight/height and DSMTES, which allowed us to reach the empirical equation: DSMTES = 4,3 + 0.044*weight, but couldn't include height, because it entered as a categorical variable.

Our aim was to include both biometric parameters in the empirical formula to estimate more accurately the average distance skin to mid-thoracic epidural space (DSMTES).

Methods:

The study included 153 patients (105 men, 48 women), submitted to combined anesthesia with thoracic epidurals for lung/oesophageal resection with effective postoperative analgesia (TEA). All patients gave their written consent.

Mann-Whitney and Kruskall-Wallis tests were used to evaluate differences in DSMTES according to sex, age and epidural space, and Spearman coefficient was used to evaluate correlation between DSMTES and age/height/weight.

Results:

DSMTES was 7.5 cm (range 3.0-12.0), was higher amongst men (p=0.018). A significantly correlation was found with height (p<0.001, R=0.400), and weight (p<0.001, R=0.420). No differences were found between medians concerning epidural spaces, although DSMTES was deeper in T5-T6.

Age had no correlation with DSMTES (p=0.924, R=0.008).

Conclusions:

In this study, we were able to find this empiric formula, including weight and height:

DSMTES= -2.347 + 0.032*weight + 4.513*height

More studies will be required to access the correlation coefficient between estimated/real DSMTES.

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