Use of Ultrasound Guidance to Assist With Labor Epidural Placement in Patients With a BMI ≥40
Overview
- Phase
- Not Applicable
- Intervention
- Not specified
- Conditions
- Labor Pain
- Sponsor
- Thomas J. Vernon
- Enrollment
- 18
- Locations
- 1
- Primary Endpoint
- Total Time Required for Epidural Catheter Placement
- Status
- Completed
- Last Updated
- 7 years ago
Overview
Brief Summary
Placement of labor epidurals is a very common daily practice in obstetrical anesthesia. Currently, these epidurals are placed based upon palpation of landmarks to determine midline and the correct spinal level for placement. Palpation of these landmarks can be difficult, however, particularly in morbidly obese patients who have significant amounts of soft tissue overlying them. This study seeks to use ultrasound guidance to examine the spine prior to epidural placement, and see what effects this has compared to palpation alone with respect to procedure time, number of attempts, success rate in the first attempt, failure rate, complication rate, patient anxiety levels, and patient satisfaction levels.
Investigators
Thomas J. Vernon
OB Anesthesia Fellow
University of Pittsburgh
Eligibility Criteria
Inclusion Criteria
- •Current (pregnant) BMI ≥ 40
- •ASA score of 3 or less
- •Full term pregnancy (37 weeks gestational age or greater)
Exclusion Criteria
- •Known scoliosis
- •Known contraindications to neuraxial blockade
- •Intrauterine fetal demise or non-viable fetus.
Outcomes
Primary Outcomes
Total Time Required for Epidural Catheter Placement
Time Frame: Assessed immediately during epidural catheter placement
Includes the time required to evaluate the spine (via ultrasound or palpation) plus the time required to successfully place the epidural catheter
Secondary Outcomes
- Epidural Procedure Time(Assessed immediately during epidural catheter placement)
- Number of Attempts at Epidural Catheter Placement(Assessed immediately during epidural catheter placement)
- Patient Anxiety Level(Assessed immediately following epidural catheter placement)
- Number of Participants Who Had Successful Placement of the Epidural Catheter in the First Attempt(Assessed immediately during epidural catheter placement)
- Complications(Assessed immediately during epidural catheter placement and within 24 hours after delivery)
- Epidural Failure Rate(Assessed within 24 hours after delivery)
- Epidural Catheter Placement Satisfaction Level(Assessed immediately following epidural catheter placement)
- Palpation or Ultrasound Time(Assessed immediately prior to epidural catheter placement)
- Overall Anesthesia Experience Satisfaction(Measured within 24 hours of delivery)