Skin to Subarachnoid Space Distance in Non pregnant females and in Parturients with Preeclampsia and without Preeclampsia

Dr Aafaque Ahmad Anjum; Dr Anjali P Savargaonkar; Dr Ramesh Narayandas Sugandh; Dr Deepak Ruparel

Volume : IX, Issue : VII, July - 2020

Skin to Subarachnoid Space Distance in Non pregnant females and in Parturients with Preeclampsia and without Preeclampsia

Dr Aafaque Ahmad Anjum, Dr Anjali P Savargaonkar, Dr Ramesh Narayandas Sugandh, Dr Deepak Ruparel

Abstract :

Background: Pre-puncture estimation of the Skin to Subarachnoid Space Distance (SSD) may be a good guide for proper spinal needle placement. It reduces the number of unsuccessful attempts, repeated attempts, traumatic or bloody lumbar puncture, and often acting as depth guide for proper spinal needle placement. Aims: To measure SSD in non-pregnant females, parturients without preeclampsia and parturients with preeclampsia and to determine if previously suggested formulae are best suited for predicting SSD in our study population. Setting and design: Observational study Materials and Methods: Five hundred and fifty-five female aged between 20 to 40 years undergoing surgery/ lower segment caesarean section under spinal anesthesia were studied at tertiary care hospital in Maharashtra. The participants were categorized into 3 groups. BMI and BSA were recorded. Prior to surgery, the subarachnoid block was performed. The depth of insertion was measured from the tip of needle up to the marked point with the help of the compass (divider) and a standard scale and noted. The SSD was compared to the predicted value of SSD by other studies. Statistical analysis: SPSS software version 20. One way ANOVA with post hoc analysis, multivariate regression and paired t tests. Results: Chong�s formulae had the lowest mean difference for all 3 groups. Chong�s formulae correlated best with observed SSD for group I, group II and group III. Multivariate linear regression analysis showed a statistically highly significant correlation with weight and age of patients in group I, whereas in group II, SSD was significantly correlated with weight, BSA, and height. In group III, SSD was correlated with BMI (p<0.01). Conclusion: SSD in all pregnant females was more than that in non-pregnant females. Among pregnant females, SSD was greater in preeclamptic females than that in non-preeclamptics. Among the various formulae, Chong�s formulae most accurately predicted the SSD when applied to our population.