ORIGINAL RESEARCH ARTICLE

The correlation between the depth extent of Tuohy epidural needle with body mass index (BMI) to achieve loss of resistance in patients undergoing epidural anesthesia

I Gusti Agung Gede Utara Hartawan , Tjokorda Gde Agung Senapathi, I Gusti Ngurah Mahaalit Aribawa, Pontisomaya Parami, Adinda Putra Pradhana, Johanis Bosco Troy Syamsuddin

I Gusti Agung Gede Utara Hartawan
Department of Anesthesiology, Pain Management, and Intensive Care, Medical Faculty of Udayana University-Sanglah General Hospital, Denpasar-Bali, Indonesia. Email: utara_hartawan@unud.ac.id

Tjokorda Gde Agung Senapathi
Department of Anesthesiology, Pain Management, and Intensive Care, Medical Faculty of Udayana University-Sanglah General Hospital, Denpasar-Bali, Indonesia

I Gusti Ngurah Mahaalit Aribawa
Department of Anesthesiology, Pain Management, and Intensive Care, Medical Faculty of Udayana University-Sanglah General Hospital, Denpasar-Bali, Indonesia

Pontisomaya Parami
Department of Anesthesiology, Pain Management, and Intensive Care, Medical Faculty of Udayana University-Sanglah General Hospital, Denpasar-Bali, Indonesia

Adinda Putra Pradhana
Department of Anesthesiology, Pain Management, and Intensive Care, Medical Faculty of Udayana University-Sanglah General Hospital, Denpasar-Bali, Indonesia

Johanis Bosco Troy Syamsuddin
Department of Anesthesiology, Pain Management, and Intensive Care, Medical Faculty of Udayana University-Sanglah General Hospital, Denpasar-Bali, Indonesia
Online First: April 28, 2019 | Cite this Article
Hartawan, I., Senapathi, T., Aribawa, I., Parami, P., Pradhana, A., Syamsuddin, J. 2019. The correlation between the depth extent of Tuohy epidural needle with body mass index (BMI) to achieve loss of resistance in patients undergoing epidural anesthesia. Bali Journal of Anesthesiology 3(1): 37-40. DOI:10.15562/bjoa.v3i1.119


ABSTRACT

Background: Anesthesia management in obesity is quite challenging. Epidural anesthesia become one of the choices. The attention should be addressed in order to prevent the misidentification of epidural space. The estimation of the depth extent of epidural space becomes crucial, especially in obese patients due to an accumulation of subcutaneous and epidural adipose tissue, which consequently complicate the epidural catheter insertion. This study aimed to analyze the correlation of the depth extent of Tuohy epidural needle to achieve loss of resistance between normal-weighted and obese patients.

Method: This study was conducted with 56 adult patients aged 17 to 65 years who underwent elective surgery by epidural anesthesia inserted at level L2-L3 or L3-L4 interspace. Subjects are divided into normal and obese groups. Shapiro-Wilk and chi-square tests were used in the normality test. For normally distributed data, an independent t-test was used to test the hypothesis, otherwise, we used Mann-Whitney test  

Results: The results showed that the loss of resistance in epidural needle insertion procedures was 60 mm in a patient with BMI more than 30 kg/m2 and 50 mm in those with BMI <30 kg/m2 (p<0.001).

Conclusion: The loss of resistance depth in epidural Tuohy needle insertion is significantly determined by BMI.

 

References

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