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Suitable Depth of Epidural Puncture in Nulliparous Pregnant Woman

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Abstract

We study the suitable depth for epidural puncture in primiparas so as to decrease epidural complications and provide anesthesiologists with an appropriate insertion guide. A prospective study of 87 primipara patients receiving labor analgesia who had epidural punctures in the course of vaginal delivery were randomly divided into 3 groups: the L 3,4 group (N = 27), the L 2,3 group (N = 29), and the L 1,2 group (N = 26). Predictive statistical models were used for the formulation of the ideal epidural puncture needle depth. Eighty two patients who had non-traumatic epidural punctures were studied. There were no significant changes in age, weight, height, weight/height ratio, gestational weeks, fetus weight, pregnancy weight, weight difference, and fetus weight (P > 0.05). Compared with L 3,4 intervertebral space, the puncture depth in L 1,2 and L 2,3 was significantly shorter (P < 0.05) and (P < 0.001), respectively; Regression equation: PD (cm) = 0.351 [LHZ] + 0.147 [BMI] + 0.017. The correlation coefficient for LHZ was 0.351 (95 % CI 0.278–0.424; P < 0.001), the correlation coefficient for BMI was 0.147 (95 % CI 0.123–0.171; P < 0.001). This formula is accurate and practical with less complex calculations. However, further validation through a prospective study will be required. It is an accurate way to localize the puncture site in parturients and improve the efficiency of puncture in parturients for analgesia labor.Epidural puncture depth prediction in L 1,2, L 2,3, and L 3,4 can supply with a related reference.

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Acknowledgments

The authors would like to acknowledge the nurses and midwives of the delivery room of our hospital for assisting in recruit nulliparous patients for this study.

Conflict of interest

The authors declared that they have no conflicts of interest to this work.

Funding

Perinatal Potential Subject (To International Peace Maternity and Child Health Hospital, Shanghai Jiaotong University School of Medicine in May, 2014).

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Authors and Affiliations

  1. Department of Gynaecology and Obstetrics, Qingpu Hospital, Fudan University School of Medicine, Shanghai, 201700, China

    Yi Luo

  2. Department of Gynaecology and Obstetrics, International Peace Maternity and Child Health Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200030, China

    Dandan Zhang & Yi Chen

  3. Department of Anesthesiology, International Peace Maternity and Child Health Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200030, China

    Jing Zheng, Qiling Yang, Xiaohu An, Dasong Yu & Zeyong Yang

Authors
  1. Yi Luo
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  2. Dandan Zhang
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  3. Jing Zheng
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  4. Qiling Yang
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  5. Xiaohu An
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  6. Yi Chen
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  7. Dasong Yu
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  8. Zeyong Yang
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Correspondence to Zeyong Yang.

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Luo, Y., Zhang, D., Zheng, J. et al. Suitable Depth of Epidural Puncture in Nulliparous Pregnant Woman. Cell Biochem Biophys 71, 875–880 (2015). https://doi.org/10.1007/s12013-014-0277-x

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  • DOI: https://doi.org/10.1007/s12013-014-0277-x

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