Vlh. Hoffmann et al., A NEW COMBINED SPINAL-EPIDURAL APPARATUS - MEASUREMENT OF THE DISTANCE TO THE EPIDURAL AND SUBARACHNOID SPACES, Anaesthesia, 52(4), 1997, pp. 350-355
A new combined spinal-epidural anaesthesia apparatus with a 27G lockab
le spinal needle was used in 151 patients. Two groups could be created
, based on whether dural perforation was felt or not (group 1: with du
ral click; group 2: no dural click). Measurements of the epidural spac
e depth and of the protrusion of the spinal needle from the epidural n
eedle (tip-to-tip distance) were made. The mean depth of the epidural
space was 5.59 cm. Correlations were found with body weight, weight-to
-height ratio and body mass index (p < 0.001). The mean tip-to-tip dis
tance measured was 7.0 mm in the patients of group 1, whereas in group
2 a distance of 8.9 mm was found. This difference was statistically s
ignificant. Correlations were found between the epidural space width a
nd the patient's height, weight-to-height ratio and body mass index. F
our patients felt paraesthesia during placement of the spinal needle a
nd, in another four patients, aspiration was necessary to detect cereb
rospinal fluid. Two patients needed epidural top-ups due to insufficie
nt level of anaesthesia. The lockable spinal needle provides safe and
stable conditions during injection and a high rate of success in reach
ing the subarachnoid space.