title: Epidural catheter placement in morbidly obese parturients with the use of an epidural depth equation prior to ultrasound visualization.
abstract: BACKGROUND
  Previously, Balki determined the Pearson correlation coefficient with the use of ultrasound (US) was 0.85 in morbidly obese parturients. We aimed to determine if the use of the epidural depth equation (EDE) in conjunction with US can provide better clinical correlation in estimating the distance from the skin to the epidural space in morbidly obese parturients.
  
  
  METHODS
  One hundred sixty morbidly obese (≥40 kg/m(2)) parturients requesting labor epidural analgesia were enrolled. Before epidural catheter placement, EDE was used to estimate depth to the epidural space. This estimation was used to help visualize the epidural space with the transverse and midline longitudinal US views and to measure depth to epidural space. The measured epidural depth was made available to the resident trainee before needle insertion. Actual needle depth (ND) to the epidural space was recorded.
  
  
  RESULTS
  Pearson's correlation coefficients comparing actual (ND) versus US estimated depth to the epidural space in the longitudinal median and transverse planes were 0.905 (95% CI: 0.873 to 0.929) and 0.899 (95% CI: 0.865 to 0.925), respectively.
  
  
  CONCLUSIONS
  Use of the epidural depth equation (EDE) in conjunction with the longitudinal and transverse US views results in better clinical correlation than with the use of US alone.
authors: Magee-Womens Hospital, Pittsburgh, PA 15213, USA.
authors: Sukhdip
authors: S
authors: Singh
authors: Keith M
authors: KM
authors: Wirth
authors: Amy L
authors: AL
authors: Phelps
authors: Manasi H
authors: MH
authors: Badve
authors: Tanmay H
authors: TH
authors: Shah
authors: Neera
authors: N
authors: Sah
authors: Manuel C
authors: MC
authors: Vallejo
mesh_terms: D000328:Adult; D000767:Anesthesia, Epidural / Q000295:instrumentation*; D002404:Catheterization / Q000379:methods*; D005260:Female; D006801:Humans; D009767:Obesity, Morbid / Q000150:complications*; D011247:Pregnancy; D011248:Pregnancy Complications; D014463:Ultrasonography; D014481:United States
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