ASSESSMENT OF SKIN-TO-EPIDURAL SPACE DISTANCE IN PEDIATRIC PATIENTS UNDERGOING SURGERIES: A SINGLE-CENTER STUDY AT THE SINDH INSTITUTE OF UROLOGY AND TRANSPLANTATION
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Keywords
Epidural, skin to epidural distance, children, tuhoy needle, anesthesia
Abstract
Background: Consider the growing gap between the skin and the epidural space, together with the potential risk of puncturing the protective meninges around the spinal cord in a narrower area, when giving lumbar and thoracic epidurals to children. The Loss of Resistance technique is used to identify the epidural space as we lack any visual modality to locate epidural space.
Objective: To determine the skin-to-epidural space distance in children presenting to Sindh Institute of Urology and Transplantation, Karachi, Pakistan.
Method: A retrospective observational study comprised a sample size of 214 participants. Consecutive non-probability sampling was employed. The study was undertaken by the anesthesia department of the Sindh Institute of Urology and Transplantation from January 2021 to December 2022. The mean and standard deviation of age, height, weight, and skin-to-epidural distance were computed. The post-stratification chi-square test results were statistically significant at a level of 0.05.
Results: The mean distance from the skin to the epidural gap was 1.74 ± 0.69 cm, with a range of 0.50 to 5 cm. The majority of individuals have an epidural distance ranging from 0.5cm to 3cm. Some individuals have an epidural distance ranging from 3.1 to 5 cm.
Conclusion: Most participants had a skin-to-epidural space distance between 0.5-3 cm. A weak positive correlation was observed between age and distance (5.1% variance), with a moderate Pearson correlation of 0.542.
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Shakil Malik
Department of Anesthesia and Surgical ICU, Sindh Institute of Urology and Transplantation Karachi, Pakistan
Syed Muhammad Abbas
Department of Anesthesia and Surgical ICU, Sindh Institute of Urology and Transplantation Karachi, Pakistan
Qamar Abbas
Department of Anesthesia and Surgical ICU, Sindh Institute of Urology and Transplantation Karachi, Pakistan
Sagar Khurana
Department of Anesthesia and Surgical ICU, Sindh Institute of Urology and Transplantation Karachi, Pakistan
Vijai Kumar
Department of Anesthesia and Surgical ICU, Sindh Institute of Urology and Transplantation Karachi, Pakistan
Zamir Ahmad
Department of Anesthesia and Surgical ICU, Sindh Institute of Urology and Transplantation Karachi, Pakistan