TY - JOUR
T1 - Accidental venous and dural puncture during epidural analgesia in obese parturients (BMI > 40 kg/m2)
T2 - Three different body positions during insertion
AU - Chanimov, Michael
AU - Evron, Shmuel
AU - Haitov, Zoya
AU - Stolero, Sorin
AU - Cohen, Mathias L.
AU - Friedland, Mark
AU - Shul, Ina
AU - Bahar, Murat
PY - 2010/12
Y1 - 2010/12
N2 - Study Objective: To assess the frequency of blood vessel punctures in morbidly obese parturients [body mass index (BMI) > 40 kg/m2] during epidural catheterization, in three different body positions. Design: Prospective, randomized study. Setting: Delivery room of a university-affiliated hospital. Patients: 347 obese parturients (BMI > 40 kg/m2) undergoing continuous epidural analgesia during labor. Interventions: Patients were randomized to undergo epidural catheterization in the sitting, lateral recumbent horizontal, or lateral recumbent head-down positions. Measurements and Main Results: A lower frequency of epidural venous cannulation was noted when this procedure was performed in the lateral recumbent head-down position (4.8%) than in the lateral recumbent horizontal (11.6%) or sitting position (18.3%) (P = 0.001). Frequency of accidental subarachnoid puncture did not differ significantly (2.5%, 2.6%, and 3.7%), respectively. Conclusion: Adoption of the lateral recumbent head-down position for the performance of lumbar epidural blockade in labor at term reduces the frequency of lumbar epidural venous puncture in obese parturients (BMI > 40 kg/m2).
AB - Study Objective: To assess the frequency of blood vessel punctures in morbidly obese parturients [body mass index (BMI) > 40 kg/m2] during epidural catheterization, in three different body positions. Design: Prospective, randomized study. Setting: Delivery room of a university-affiliated hospital. Patients: 347 obese parturients (BMI > 40 kg/m2) undergoing continuous epidural analgesia during labor. Interventions: Patients were randomized to undergo epidural catheterization in the sitting, lateral recumbent horizontal, or lateral recumbent head-down positions. Measurements and Main Results: A lower frequency of epidural venous cannulation was noted when this procedure was performed in the lateral recumbent head-down position (4.8%) than in the lateral recumbent horizontal (11.6%) or sitting position (18.3%) (P = 0.001). Frequency of accidental subarachnoid puncture did not differ significantly (2.5%, 2.6%, and 3.7%), respectively. Conclusion: Adoption of the lateral recumbent head-down position for the performance of lumbar epidural blockade in labor at term reduces the frequency of lumbar epidural venous puncture in obese parturients (BMI > 40 kg/m2).
KW - Anesthesia, Complications
KW - Obesity
KW - Patient position
KW - Venous puncture
UR - http://www.scopus.com/inward/record.url?scp=78649526808&partnerID=8YFLogxK
U2 - 10.1016/j.jclinane.2010.06.004
DO - 10.1016/j.jclinane.2010.06.004
M3 - ???researchoutput.researchoutputtypes.contributiontojournal.article???
AN - SCOPUS:78649526808
VL - 22
SP - 614
EP - 618
JO - Journal of Clinical Anesthesia
JF - Journal of Clinical Anesthesia
SN - 0952-8180
IS - 8
ER -