Anon Invasive Confirmatory Sign for Correct Epidural Catheter Placement During Normal Vaginal Delivery
试验速览
- 阶段
- 不适用
- 状态
- 尚未招募
- 入组人数
- 100
- 主要终点
- appearance of the dew sign
研究概览
简要总结
Epidural anesthesia for pain control during normal vaginal delivery is a blind maneuver and so we need a confirmatory sign for being in the correct epidural space.
Loss of resistance sign using air may guide us wrongly as it may occur if we entered into the paravertebral muscles or cavities in the interspinal ligaments.
So, additional confirmatory sign beside loss of resistance sign by air is strongly needed.
We noticed that after occurence of loss of resistance sign by air and insertion of the epidural catheter a dew was formed on the internal sides of the epidural catheter after aspiration to be sure that there are no blood or cerebrospinal fluid in the catheter.
This dew formation (Ramy sign) is characteristic for air in the epidural space when transferred from the warm epidural space (temperature about 38-39 celsius degree) to the colder aspect of the catheter outside the patient which nearly has the same operating room temperature (22 celsius degree).
This sign may be associated with correct placement and good function of the epidural catheter.
详细描述
parturient for normal vaginal delivery are examined for correct epidural catheter placement by loss of resistance technique by air, observation of the dew sign and epidurogram.
Visual analogue score is used to test pain. blood pressure and heart rate after epidural injection will be monitored
研究设计
- 研究类型
- Interventional
- 分配方式
- Na
- 干预模型
- Single Group
- 主要目的
- Treatment
- 盲法
- None
入排标准
- 年龄范围
- 18 Years 至 45 Years（Adult）
- 性别
- Female
- 接受健康志愿者
- 否
入选标准
- •Parturient for normal vaginal delivery
- •American society of anesthesiologists 2
排除标准
- •patients refusal
- •back infection
- •anticoagulant non stopped
- •platelets count less than 100000
- •international normalization ratio more than 1.4
- •severe cardiac or respiratory diseases
- •haemodynamics unstable patients
结局指标
主要结局
appearance of the dew sign
时间窗: immediately during aspiration of the epidural catheter
dew formation inside the outer portion of the epidural catheter near the patient
次要结局
- mean blood pressure(30 minutes after epidural injection by 10 milliliter bupivacaine 0.25%)
- heart rate(30 minutes after epidural injection by 10 milliliter bupivacaine 0.25%)
- epidurogram(immediately after epidural catheter insertion)
- visual analogue score(20 minutes after epidural injection by 10 milliliter bupivacaine 0.25%)
研究者
RAMY AHMED
Assistant Professor of Anesthesia
Ain Shams University