International Journal of Advances in Medicine | December 2020 | Vol 7 | Issue 12 Page 1846
International Journal of Advances in Medicine
Bala M et al. Int J Adv Med. 2020 Dec;7(12):1846-1849
http://www.ijmedicine.com
pISSN 2349-3925 | eISSN 2349-3933
Original Research Article
Correlation of distance from skin to lumbar epidural space with
age and height of patients
Manju Bala
1
, Monica Chhikara
1
*, Deepika
1
, Kiranpreet Kaur
1
, Teena Bansal
1
, Sabiha Naz
2
INTRODUCTION
Epidural anaesthesia is a central neuraxial block
technique which acts by blocking spinal nerves in
epidural space at the point of their emergence from dura
before entering into intervertebral foramina. It was
introduced in 1885 by corning and subsequent
improvement in equipment, drugs and technique in last
century has made it a popular and versatile procedure.
1
Epidural space is a potential space that lies between the
dura and the periosteum lining the inside of vertebral
canal.
2
This space can be reached in a midline sagittal
plane by penetrating skin, subcutaneous tissues,
supraspinous ligament, interspinous ligaments and
ligamentum flavum.
3
Since it is a blind procedure, it is difficult to accurately
identify the epidural space resulting into 1.5% failure
rate. This can be due to excess fat, undue ossification or
repeated puncture of the dura mater.
4
Various techniques
have been used for localizing epidural space. These
techniques are mainly based on either negative pressure
1
Department of Anaesthesia,
2
Department of Biochemistry, Pt. B. D. Sharma PGIMS Rohtak, Haryana, India
Received: 13 October 2020
Revised: 19 November 2020
Accepted: 20 November 2020
*Correspondence:
Dr. Monica Chhikara,
E-mail: chhikara.monica@gmail.com
Copyright: © the author(s), publisher and licensee Medip Academy. This is an open-access article distributed under
the terms of the Creative Commons Attribution Non-Commercial License, which permits unrestricted non-commercial
use, distribution, and reproduction in any medium, provided the original work is properly cited.
ABSTRACT
Background: Epidural block is a popular and versatile procedure with applications as sole anaesthetic, as an
analgesic adjuvant to general anaesthesia and for post-operative analgesia in procedures involving lower limbs,
perineum, pelvis, abdomen and thorax. However, success of the epidural technique depends upon the correct
identification of epidural space. The knowledge of distance from skin to epidural space can help in better
identification of epidural space and epidural catheter placement with fewer incidences of complications. We
conducted a study to find the distance from skin to the epidural space and its correlation with patient height and age to
improve the success rate.
Methods: Seventy-four patients scheduled to undergo lower lumbar surgeries where epidural block was required as
anaesthetic or analgesic, were included in the study. These patients were randomly divided into four different groups
of 37 patients each according to their age (group A and group B) and height (group C and group D). In these patient’s
epidural block was given by standard technique according to the need of surgery and epidural depth measured.
Obtained results were compared among group A, B and group C, D depending on their age and height respectively.
Results: In group A (age 20-30 years), mean epidural depth was 3.96±0.4 cm while in group B (age 30-40 years)
mean epidural depth was 4.05±0.5 centimeters. In group C (height 155-169 cm) mean epidural depth was 3.88±0.4
centimeters while it was 4.13±0.5 centimeters in group D (height 170-184 cm).
Conclusions: There was increase in epidural depth with increase in height of patients but there was no correlation
between age of patients and epidural depth.
Keywords: Epidural depth, Age, Height
DOI: https://dx.doi.org/10.18203/2349-3933.ijam20205046