Depth of epidural space - obese patients

[IMGASMD]

I am more interested in how she got pregnant. lol

Back into it.

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[De68801]

Thanks for the replies. I just had a 300 lb patient with scoliosis, but she could hold still and speak English. I was able to verbally confirm with her that I was midline, and finally got LOR with the needle tented! Epidural worked great. The US is a great idea, as is placing spinal needle through Tuohy to verify epidural space. A lot of the problem is that patients do not speak English, are not able to hold still, and many of them are very short, (4 foot 5inch is a common height), and can't arch their backs around the large gravid uterus.

 

[dhb]

can't arch their backs

Put a taco just out of reach in front of them and watch that lumbar space open up.