Determinación de la localización anatómica de la línea de Tuffier en pacientes sometidos a anestesia neuroaxial mediante ultrasonografía. Hospitales Vicente Corral y José Carrasco. Cuenca, 2018

Abstract

Background. Tuffier line, identified by palpation, is a must reference for the puncture in neuroaxial anesthesia and from its initial description it has been accepted that it passes through the spiny apophysis of L4 or l4-L5 interspace. However, new studies report that its location varies if other methods are used to identify it. Objective. Determine the height of the Tuffier line with ultrasonography in patients undergoing neuroaxial anesthesia in the Vicente Corral and José Carrasco hospitals. Material and methods. With a descriptive design, 350 patients undergoing neuroaxial anesthesia were included. Demographic and clinical variables were characterized. The association of the height of the Tuffier line was sought with: sex, age, weight, height and nutritional status. The exact height of the line was recorded by ultrasound. The information was analyzed with descriptive statistics. Results. The location of the Tuffier line by palpation had a coincidence of 25.1% with respect to ultrasound. In 66.6% one space was located above and in 8.3% two spaces above. The height of the line was higher at an older age (Pearson: 0.189, p = 0.001), in women (p = 0.005) and at a higher body mass index (p <0.001). In a subgroup of greater stature the anatomic location of the line was lower (p = 0.006). Conclusion. You should confirm the height of the Tuffier line by ultrasound to avoid neuroaxis damage with neuroaxial anesthesia since palpation fails.