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British Journal of Anaesthesia, 2000, Vol. 85, No. 6 841-843
© 2000 The Board of Management and Trustees of the British Journal of Anaesthesia

Sonographic measurement of needle insertion depth in paravertebral blocks in women

F. Pusch1, E. Wildling2, W. Klimscha1 and C. Weinstabl1

1Department of Anaesthesia and General Intensive Care, University Hospital of Vienna, Waehringer Guertel 18–20, A-1090 Vienna, Austria. 2Department of Anaesthesia and General Intensive Care, Hospital of Korneuburg, Wiener Ring 3–5, A-2100 Korneuburg, Austria*Corresponding author

Single-injection paravertebral block offers adequate unilateral analgesia for thoracic and upper abdominal surgery. This technique is easy to learn but there is a risk, albeit low, of pleural puncture. The aim of the study was to determine whether sonographic measurements of the distances from the skin to the transverse process and to the parietal pleura are useful for calculating the required depth of needle insertion. Before puncture of the paravertebral space, the distances from the skin to the transverse process and to the parietal pleura were measured by sonography. The deviation of the needle from the horizontal plane was measured and an angle correction for the insertion depth was calculated. Twenty-two women undergoing elective unilateral breast surgery were studied. Sonographic visualization of the transverse process and the parietal pleura and measurement of their distances from the skin was successful in all women. Puncture of the paravertebral space failed in one obese woman. There was a very close correlation between needle insertion depth from the skin to the transverse process and the distance measured by ultrasound if angle correction was used (adjusted r2=0.95). Similarly, there was excellent correlation between the angle-corrected ultrasound distance from the skin to the parietal pleura and the distance from the skin to the paravertebral space (adjusted r2=0.92).

Br J Anaesth 2000; 85: 841–3


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