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Korean Journal of Anesthesiology 1999;37(6):1060-1067.
DOI: https://doi.org/10.4097/kjae.1999.37.6.1060   
A Study on the Distance from Epidural Space to Subarachnoid Space in Combined Spinal-Epidural Anesthesia for Cesarean Section.
Hyeweon Shin, Woon Young Kim, Kuy Suk Suh
Department of Anesthesiology, Seoul Eulji General Hospital, Seoul, Korea.
Abstract
BACKGROUND
Combined spinal-epidural anesthesia (CSEA) has gained an increasing interest as it combines the reliability of a spinal block and the flexibility of an epidural block. This study was designed to determine the distance from skin to epidural space (S-EP) and the distance from epidural space to subarachnoid space (E-SA) in obstetric parturient and whether weight, height, BMI (body mass index) and PI (ponderal index) might influence S-EP and E-SA.
METHODS
Sixty obstetric patients undergoing elective cesarean section during CSEA in L3-4 level were partitioned into group I (with dural click), group II (no dural click) and in each group, weight (prepregnancy, pregnancy), height, BMI and PI were measured. Measurements of S-EP and E-SA were made. The Pearson correlation was used to investigate relationships between S-EP, E-SA and patient characteristics (height, weight, BMI, PI).
RESULTS
S-EP was 4.39+/-0.49 cm and E-SA was 8.23+/-2.05 mm (7.99+/-2.07 mm in group I, 8.78+/-1.94 mm in group II). S-EP was related to weight, BMI and PI except height. E-SA was related to pregnancy BMI and pregnancy PI in group I. No correlation was found between E-SA and other variables in group II.
CONCLUSIONS
E-SA in obstetric parturients was related to obesity and has been found to be somewhat larger and more variable due to the segmented and discontinous nature of epidural space.
Key Words: Anesthetic technique, combind spinal epidural; Lumbar, distance; Surgery, obstetric, cesarean section


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