Aamer Mahmood Malak, Asad Shameem, Jamshed Ahmed Rahmani, Muhammad Zaheer Haider.
Skin to posterior Lumbar epidural space distance.
J Coll Physicians Surg Pak Jan ;17(3):125-7.

Objective: To measure the clinically relevant skin to posterior lumbar epidural space distance in adult surgical patients and to correlate this distance with the patient physical factors to construct a model for the prediction of this distance using the correlation. Design: A cross-sectional study. Place and Duration of Study: Department of Anaesthesiology, P.A.F Hospital, Islamabad over a period of 18 months from 1st January 2003 to 30th June 2004. Patients and Methods: The study was carried out in 100 patients divided into three groups, who were scheduled for different surgical procedures. Group-I consisted of female patients scheduled for lower segment caesarian section (L.S.C.S); group-II adult non-pregnant females undergoing elective surgery and group-III adult males undergoing different surgical procedures. Epidural anaesthesia was given, using loss of resistance (LOR) technique, and skin to posterior epidural space was measured. Results: The mean skin to posterior lumbar epidural space distance was found to be 3.8 ± 0.5 cm in group-I, 3.76 ± 0.7 cm in group- II and 4.0 ± 0.5 cm in group-III. Skin to posterior epidural space distance correlates best with weight of the patient. Conclusion: Posterior lumbar skin to epidural space distance has been found to be less than what is normal in rest of the world. These results may be used as a guideline for performing successful epidural blocks in Pakistani population. A reliable model using patient physical factors to predict skin to posterior epidural space distance could not be constructed.

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