Is the Spinous Process of T7 Usually at the Same Level as the Inferior Tips of the Scapulae?.
- Author:
Mun Gyu KIM
1
;
Si Young OK
;
Sang Ho KIM
;
Se Jin LEE
;
Sun Young PARK
;
Eun Hyo KOH
;
Heon Yong BAE
;
Kyung Yul HUR
Author Information
1. Department of Anesthesiology and Pain Medicine, Soonchunhyang University Seoul Hospital, Soonchunhyang University College of Medicine, Seoul, Korea. syok2377@naver.com
- Publication Type:Original Article
- Keywords:
Scapular lower tips;
Seventh cervical spinous process;
Seventh thoracic spinous process;
Surface anatomy landmark;
Thoracic epidural puncture
- MeSH:
Analgesia;
Analgesia, Epidural;
Arm;
Catheters;
Humans;
Neck;
Needles;
Punctures;
Thoracic Vertebrae;
Thorax
- From:Soonchunhyang Medical Science
2012;18(1):9-11
- CountryRepublic of Korea
- Language:English
-
Abstract:
OBJECTIVE: Appropriate placement of thoracic epidural catheter provides an adequate postoperative analgesia in chest and upper abdominal surgery. Usually, when thoracic epidural puncture is performed, both scapular lower tips and the thoracic (T)7 spinous process is assumed to be at the same horizontal level. The aim of this study is to identify the thoracic epidural puncture in the sitting position, with the neck flexed and arms crossed, may change the relationship between the thoracic vertebrae and the scapular lower tips. METHODS: One hundred patients with postoperative patient controlled epidural analgesia using thoracic epidural catheters were enrolled. It is presumed that the both scapular lower tips and T7 spinous process is at the equal level when performing thoracic epidural puncture. The actual insertion level of the Tuohy needle was examined by radiography when the patient was in the sitting position. RESULTS: Out of 100 patients, there were 62% that were in the same level as the scapular lower tips and T7 spinous process. However, 1% of the patients leveled at T4, 1% at T5, 25% at T6, 18% at T8, and 1% at T9. CONCLUSION: When performing the thoracic epidural puncture under the sitting position, the relationship of the T7 and the scapular lower tips may change. The change of position of scapular lower tips varied among T6.82+/-0.70. Therefore, to be precise, it is advised to utilize C-arm guide when epidural puncture is carried out.
