None listed
Conditions
Brief summary
combined spinal epidural anesthesia is frequently used for cesarean section in our institution. Conventional palpation method has widely been used to locate the intervertebral space resulting in some complications. with the developments in technology and widespread use of ultrasound, precise navigation of intervertebral space is easier with almost exact results. ultrasound guides the anesthesiologist to navigate the desired intervertebral space to introduce the epidural needle, gives provision of the precise insertion angle for the needle and predicts the depth of epidural space where epidural needle can be introduced safely. this results in reduced complications and increased patient safety. There is a almost no data in the literature comparing the correlation of ultrasonographic measurements of epidural depth at saggital paramedian oblique plane and transverse plane with the actual epidural depth. The aim of the current study is to measure the epidural depth with ultrasound at saggital paramedian oblique plane and transverse plane in parturients scheduled for elective cesarean section with combined spinal epidural anesthesia and determine the correlations of these measurements with the actual epidural depth.
Interventions
The measurements will be done at the operation room after monitorization of the parturient in accordance with the standards of American Society of Anesthesiologists. Patient will be placed at sitting position on the operation table and ultrasonography will be done at this position which will also be the position for combined spinal epidural anesthesia. An anesthesiologist experienced in sonoanatomy will do the ultrasonographic examination of epidural space in both transverse and sagittal paramed
The measurements will be done at the operation room after monitorization of the parturient in accordance with the standards of American Society of Anesthesiologists. Patient will be placed at sitting position on the operation table and ultrasonography will be done at this position which will also be the position for combined spinal epidural anesthesia. An anesthesiologist experienced in sonoanatomy will do the ultrasonographic examination of epidural space in both transverse and sagittal paramedian oblique plane. The depth of epidural space in both examinations will be recorded. While performing combined spinal epidural anesthesia, after aseptic preparing the skin and infiltration of entry site for epidural needle with local anesthetic drug, epidural needle will be introduced from skin through epidural space with loss of resistance technique. At the point epidural space is reached, epidural needle will be marked with a sterile permenant marker and after introducing spinal needle through epidural needle, free flow of cerebrospinal fluid will be observed, spinal needle will be locked within the epidural needle and 2ml 0.5% hyperbaric bupivacaine will be injected. The distance between the tip of epidural needle and the spinal needle will be measured. The actual depth of epidural space will be measured as the distance marked on the epidural needle to its tip. The depth of subarachnoid space will be accepted as the distance between the tip of spinal needle and the tip of epidural needle plus the measured actual epidural depth which was formerly defined.
Sponsors
mehmet cantürk
Eligibility
Sex/Gender
All
Age
18 Years to 40 Years
Healthy volunteers
No
Inclusion criteria
parturients undergoing elective cesarean section with combined spinal epidural anesthesia
Exclusion criteria
multiple and/or complicated pregnancies, eclampsia, preeclampsia, American society of anesthesiologists physical risk score >II, Any contraindication for combined spinal epidural anesthesia, coagulopathy and/or anticoagulant drug use , patient refusal to participate to study, and emergency cases.
Outcome results
None listed