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Related Concept Videos

Local Anesthetics: Clinical Application as Epidural Anesthesia01:29

Local Anesthetics: Clinical Application as Epidural Anesthesia

Epidural anesthetics are administered in the fat-filled epidural space, the outermost part of the spinal canal. This technique is commonly employed for pain management and anesthesia during lower abdomen and pelvis surgeries or labor and delivery.
Since epidural anesthetics can be infused through an epidural catheter, all types of drugs, including short-acting ones, can be administered. Chloroprocaine and lidocaine are examples of short and long-duration anesthetics, respectively. Bupivacaine...
Local Anesthetics: Clinical Application as Spinal Anesthesia01:11

Local Anesthetics: Clinical Application as Spinal Anesthesia

Spinal anesthetics are given during lower abdomen and limb surgeries to block sensory and motor neurons. They are administered in the mid to low lumbar regions, primarily acting on the cauda equina's nerve roots. The blockade level depends on the local anesthetic (LA) concentration. Usually, low LA concentrations are sufficient to block sensory fibers, while only high LA concentrations block motor fibers. Other factors like injection volume and speed, the patient's posture, and the drug...

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Related Experiment Video

Updated: May 23, 2026

Spinal Sonography for Ultrasound-Guided Lumbar Neuraxial Anesthesia
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Cervical epidural depth: correlation between needle angle, cervical anatomy, and body surface area.

Michael K Fujinaka1, Erin F Lawson, Gery Schulteis

  • 1University of California, San Diego, School of Medicine, La Jolla, California 92037-1300, USA.

Pain Medicine (Malden, Mass.)
|April 13, 2012
PubMed
Summary

Predicting cervical epidural space depth for epidural steroid injections is challenging. While some body measurements correlate, models lack clinical confidence for safe needle placement and preventing cord injury.

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Area of Science:

  • Anesthesiology
  • Neurosurgery
  • Radiology

Background:

  • Cervical interlaminar epidural steroid injections (CIESI) carry risks, including potential cord injury.
  • Accurate knowledge of the depth from the lamina to the epidural space is crucial for safe CIESI procedures.

Purpose of the Study:

  • To evaluate the predictability of cervical epidural space depth using external body measurements and anatomical landmarks.
  • To assess the accuracy of regression models in predicting needle depth for CIESI.

Main Methods:

  • Prospective analysis of 92 subjects undergoing fluoroscopically guided C7-T1 intralaminar epidural steroid injections.
  • Data collected included patient demographics, anthropometric measurements, and needle depths to lamina and epidural space.

Main Results:

  • Depth to lamina was the strongest individual predictor (r=0.86).
  • Weight, neck circumference, and BMI positively correlated with epidural space depth (r=0.66, 0.62, 0.61).
  • Regression models predicted depth within ±0.5 cm in 69% of subjects, but individual predictions varied by up to 1.7 cm.

Conclusions:

  • Statistically significant correlations exist between external characteristics and epidural space depth.
  • Optimal regression models do not provide sufficient clinical confidence for predicting epidural space depth in CIESI.
  • Further research is needed to improve the safety and accuracy of CIESI.