Prediction of depth from skin to subarachnoid space based on preoperative anthropometric assessment: an observational study

Mamta  Khandelwal; Ekta  Tiwari; Priyanka  Jain; Chitra Singh; Nachiketa  Bharadwaj; Darshan N

doi:10.18231/j.joapr.2023.11.3.24.28

Authors

Mamta Khandelwal Department of Anesthesia, SMS Medical College and Attached Hospitals, Jaipur, Rajasthan
Ekta Tiwari Department of Anesthesia, SMS Medical College and Attached Hospitals, Jaipur, Rajasthan
Priyanka Jain Department of Anesthesia, SMS Medical College and Attached Hospitals, Jaipur, Rajasthan
Chitra Singh
Nachiketa Bharadwaj Department of Anesthesia, SMS Medical College and Attached Hospitals, Jaipur, Rajasthan
Darshan N Department of Anesthesia, SMS Medical College and Attached Hospitals, Jaipur, Rajasthan

DOI:

https://doi.org/10.18231/j.joapr.2023.11.3.24.28

Keywords:

Skin to subarachnoid depth (SSD), Anthropometry, Sub Arachnoid Block

Abstract

Background and aim: An accurate placement of spinal needle is crucial while injecting drugs to avoid a failed sub arachnoid block (SAB). A pre puncture estimation of skin to subarachnoid depth (SSD) may guide accurate spinal needle placement. This study is aimed to predict the depth from skin to subarachnoid space based on pre-operative anthropometric assessment and to find out formula for predicting SSD, best suited in terms of accuracy when compared with observed depth. Method: In this hospital based, prospective, observational study, a total of 120 patients, of which 68 were men, and 52 were women (non-pregnant) with a mean age of 59.75 ±14.1 kilograms. The SSD was measured after SAB was performed. This SSD was compared with the predicted SSD calculated using the Abe’s, Bonadio’s, Craig’s, Stocker’s, and Chong’s modified formulae. Analysis was done using unpaired t test for quantitative data to determine best suited formula to predict SSD in our population in terms of both accuracy and ease of application. Pearson correlation test was also done. Results: The observed SSD in the overall study population was 4.96 ± 0.67 cm. Stocker’s formula is closest with a mean difference of 0.17cm. In males the mean observed depth was (5.06±0.60 cm) more than that in the non-pregnant female population (4.83±0.74cm). These anthropometric variables were statistically significant with a presentation value of <0.001. Conclusion: Among various formulae Stocker’s formula can most accurately predict the SSD when applied to Indian population.

Downloads

Download data is not yet available.

References

Prakash S, Mullick P, Chopra P, Kumar S, Singh R, Gogia AR. A prospective observational study of skin to subarachnoid space depth in the Indian population. Indian J Anaesth 58, 165-70 (2014)

Abe KK, Yamamoto LG, Itoman EM, Nakasone TA, Kanayama SK. Lumbar puncture needle length determination. Am J Emerg Med 23, 742-6 (2005)

Bonadio WA, Smith DS, Metrou M, Dewitz B. Estimating lumbar-puncture depth in children. N Engl J Med 319, 952-3 (1988)

Craig F, Stroobant J, Winrow A, Davies H. Depth of insertion of a lumbar puncture needle. Arch Dis Child 77, 450 (1997)

Stocker DM, Bonsu B. A rule based on body weight for predicting the optimum depth of spinal needle insertion for lumbar puncture in children. Acad Emerg Med. 5, 105–6 (2015)

Chong SY, Chong LA, Ariffin H. Accurate prediction of the needle depth required for successful lumbar puncture. The American Journal of Emergency Medicine 28(5), 603–606 (2010)

Taman HI, Farid AM, Abdelghaffar WM. Measuring skin to subarachnoid space depth in Egyptian population: A prospective cohort study. Anesth Essays Res 10, 468-72 (2016)

Basgul A, Hancy A, Korkmas F, Eksyoglu B. A clinical prediction of skin to lumbar epidural space distance in the urologic surgery patients: 125. Reg Anesth Pain Med. 29 (Suppl 2), 52 (2005)

Hazarika R, Choudhury D, Nath S, Parua S. Estimation of Skin to Subarachnoid Space Depth: An Observational Study. J Clin Diagn Res 10, UC06-UC09 (2016)