None listed
Conditions
Interventions
Procedure/Surgery : According to previous reports of ultrasound guided epidural catheter insertion, patients were placed in a sitting position during the procedure. However, in our experience, the fix
Sponsors
Asan Medical Center
Eligibility
Sex/Gender
All
Inclusion criteria
Inclusion criteria: - Patients scheduled upper abdominal surgery or thoracic surgery who require thoracic epidural catheter placement at the T6-12 level - Adult patients (20–80 years) were considered eligible for enrollment - Patients who voluntarily consent to this clinical study
Exclusion criteria
Exclusion criteria: - allergy to local anesthetics and contrast dye or steroids - coagulopathy or infection or use the anticoagulants or antiplatelet medication - neurological or psychiatric disorders - does not agree to participate in the study - prior spine instrumentation or compression fracture near the insertion site
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| needling time: Time for epidural needle to reach the epidural space after skin puncture | — |
Secondary
| Measure | Time frame |
|---|---|
| Patient comfort scale(Grade 0=help, 2=uncomfortable, 4=mild discomfort, 6=feeling OK, 8=pretty comfy, 10=feeling great);Numeric rating scale during the procedure;Success or failure: If LOR is not obtained despite a total of 9 needle passes, or if 1% lidocaine is injected after LOR, it is considered a failure if it is not epidural;Procedure related complications: epidural puncture, hematoma, nerve injury;First attempt success: When reaching the epidural space at once after skin puncture without backward movement of the epidural needle;total number of needle passes: First needle pass + additional needle passes (If the epidural needle hits the vertebral arch or spinous process and it is impossible to advance, it is considered as the number of needle passes to move backward and re-direction);Time to mark space: time to check the structure and skin puncture site by ultrasound and to mark the skin;Ultrasound visibility score (0: not visible, 1: poorly visible, 2: well visible, total score: 8): Visibility of 4 target structures on ultrasound: a.lamina, b.interlamina space, c.posterior complex, d.anterior complex, is measured;Global rating scale (? ??? 1~5?, total score 15): Based on three items: a.Time and motion, b.Instrument handling, and c.Flow of operation, the technical skill is evaluated during the procedure according to the posture.;Number of skin punctures: complete needle withdrawal from the skin and reinsertion at a new location | — |
Countries
Korea, Republic of
Contacts
Public ContactSojin Shin
Asan Medical Center
Outcome results
None listed