Ultrasound-Guided Technique for Thoracic Epidural Insertion: A Randomized Controlled Trial
试验速览
- 阶段
- 不适用
- 状态
- 已完成
- 发起方
- 入组人数
- 60
- 试验地点
- 4
- 主要终点
- Needle redirections
研究概览
简要总结
Thoracic epidural analgesia and anesthesia are effective in improving the quality of intraoperative and postoperative pain relief during thoracic and abdominal surgical procedures. Conventional epidural techniques have significant limitations. Due to the anatomic characteristics of the thoracic versus the lumbar intervertebral spaces, the insertion requires a more technically challenging paramedian approach. The safety and feasibility of bedside ultrasonography for the lumbar spine has already been established and it proves to be a valuable tool for neuraxial anesthesia in obstetric anesthesia
详细描述
• The feasibility and the reliability of US imaging for the thoracic spine has been proven by comparing the findings of ultrasound scans to MRI measurements, which is the standard imaging technique for the depiction of the spine. Pre-puncture US assessment may contribute to the safety and efficacy of the thoracic epidural technique. The purpose of this study is to compare the ultrasound-guided thoracic epidural insertion technique with the conventional anatomic landmarking technique of contacting bone and walking-off the lamina
研究设计
- 研究类型
- Interventional
- 分配方式
- Randomized
- 干预模型
- Parallel
- 主要目的
- Treatment
- 盲法
- None
入排标准
- 年龄范围
- 18 Years 至 —（Adult, Older Adult）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •Age > 18 years old.
- •Elective major abdominal or thoracic surgery requiring thoracic epidural anesthesia/analgesia.
- •Consent to participate and signed consent form.
排除标准
- •Contraindication to epidural anesthesia.
- •Marked spinal deformities or a history of spinal instrumentation
- •Emergency surgery.
- •Inability to communicate in English.
- •BMI>35 kgm-2
结局指标
主要结局
Needle redirections
时间窗: 30 minutes
Number of needle redirections defined as the need to withdraw the epidural needle for the purpose of continuing on a different angle (sagittal or axial plane)
次要结局
- duration of ultrasound scanning(30 minutes)
- Bony contacts(30 minutes)
- New insertion point(30 minutes)
- Number of insertions(30 minutes)
- duration of epidural procedure(30 minutes)
- complications during epidural insertion(30 minutes)