دورية أكاديمية
A comprehensive, bed-side scoring system to predict difficult lumbar puncture.
| العنوان: | A comprehensive, bed-side scoring system to predict difficult lumbar puncture. |
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| المؤلفون: | Subramanian S; Department of Anesthesiology, Dr. B. R. Ambedkar Medical College and Hospital, Gandhi Nagar, Kadugondanahalli, Bengaluru, Karnataka, India., Reshma BM; Department of Anesthesiology, Dr. B. R. Ambedkar Medical College and Hospital, Gandhi Nagar, Kadugondanahalli, Bengaluru, Karnataka, India., Salim Iqbal M; Department of Anesthesiology, Dr. B. R. Ambedkar Medical College and Hospital, Gandhi Nagar, Kadugondanahalli, Bengaluru, Karnataka, India., Harsoor SS; Department of Anesthesiology, Dr. B. R. Ambedkar Medical College and Hospital, Gandhi Nagar, Kadugondanahalli, Bengaluru, Karnataka, India. |
| المصدر: | Journal of anaesthesiology, clinical pharmacology [J Anaesthesiol Clin Pharmacol] 2023 Jan-Mar; Vol. 39 (1), pp. 38-44. Date of Electronic Publication: 2022 Jan 28. |
| نوع المنشور: | Journal Article |
| اللغة: | English |
| بيانات الدورية: | Publisher: Research Society of Anaesthesiology Clinical Pharmacology Country of Publication: India NLM ID: 9516972 Publication Model: Print-Electronic Cited Medium: Print ISSN: 0970-9185 (Print) Linking ISSN: 09709185 NLM ISO Abbreviation: J Anaesthesiol Clin Pharmacol Subsets: PubMed not MEDLINE |
| أسماء مطبوعة: | Original Publication: New Delhi, India : Research Society of Anaesthesiology Clinical Pharmacology, |
| مستخلص: | Background and Aims: Spinal anesthesia (SA) is the most widely practiced neuraxial anesthesia. Lumbar puncture (LP) at multiple levels and multiple attempts due to any reason may cause discomfort and even serious complications. Hence the study was conducted to evaluate the patient variables that can predict difficult LP thus allowing for the use of alternate techniques. Material and Methods: We included 200 patients of ASA physical status I-II, scheduled to undergo elective infra-umbilical surgical procedures under spinal anesthesia. During preanesthetic evaluation, difficulty score was assessed using the 5 variables: Age, abdominal circumference, spinal deformity - assessed as axial trunk rotation (ATR) value, anatomical spine assessed by spinous process landmark grading system (SLGS) and patient position, by assigning a score of 0- 3 for each variable, with a total score of 0 - 15. The difficulty of LP was graded as easy, moderate or difficult based on total number of attempts and spinal levels by independent experienced investigator. The scores obtained during preanesthetic evaluation and the data collected after performing LP were analyzed using multivariate analysis and P value noted. Results: Our study showed that above patient variables correlated well with difficult LP scoring ( P < 0.001). SLGS was noted to be a strong predictor, while ATR value a weak predictor. The correlation between the total score and grades of SA had a positive association (R = 0.6832, P < 0.00001) and was statistically significant. A median difficulty score of 2, 5 and 8 predicted easy, moderate and difficult LP respectively. Conclusion: The scoring system provides for a useful tool to predict difficult LP and helps both patient and anesthesiologist to choose an alternative technique. Competing Interests: There are no conflicts of interest. (Copyright: © 2022 Journal of Anaesthesiology Clinical Pharmacology.) |
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| فهرسة مساهمة: | Keywords: Abdominal circumference; difficult spinal lumbar puncture; scoliometer smart app; scoring system; spinal anesthesia |
| تواريخ الأحداث: | Date Created: 20230530 Latest Revision: 20231031 |
| رمز التحديث: | 20231101 |
| مُعرف محوري في PubMed: | PMC10220197 |
| DOI: | 10.4103/joacp.JOACP_77_21 |
| PMID: | 37250250 |
| قاعدة البيانات: | MEDLINE |
Full Text Finder | تدمد: | 0970-9185 |
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| DOI: | 10.4103/joacp.JOACP_77_21 |