None listed
Conditions
Interventions
Procedure/Surgery : All patients are placed in the prone position with a pillow under the upper abdomen to widen the target interlaminar space. Routine monitoring is established prior to the procedure
Sponsors
Asan Medical Center
Eligibility
Sex/Gender
All
Inclusion criteria
Inclusion criteria: 1) Patients who undergo open thoracic or abdominal surgery 2) Patients who is required thoracic epidural catheter placement 3) 20 = age <80 4) Patients who want to participate in this study and write informed consent voluntarily.
Exclusion criteria
Exclusion criteria: 1) An allergy to local anesthetics and contrast dye 2) Patients who are contraindicated in nerve block such as coagulopathy, antiplatelet therapy, infection 3) Neurological or psychiatric disorders 4) Pregnancy 5) Patients who had surgery on the thoracic spine 6) Patients who had thoracic compression fracture 7) Patients who do not want to participate in this study
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| First attempt success: achievement of LOR and successful catheter placement on first needle pass and first skin puncture | — |
Secondary
| Measure | Time frame |
|---|---|
| immediate postoperative pain after surgery (assessed by a numeric rating scale (0 ~ 10)).;Time to mark spaces (seconds): the time to obtain the best ultrasound or fluoroscopic images of the target space, and mark the overlying skin;Needling time: time to access the epidural space after skin insertion;Total number of needle passes: first needle pass plus additional needle passes, that is, re-advancement of the needle after any needle withdrawal for changing the direction;Number of skin punctures: first skin puncture plus additional skin punctures, that is, reinsertion at a new location after complete needle withdrawal from the skin;Final success: achievement of LOR and successful catheter placement within allowed epidural access attempts per protocol, which should be confirmed by contrast dispersion in the epidural space / Failure: Failure of catheter placement within allowed epidural access attempts;Crossover trial success: achievement of LOR and successful catheter placement, using another group’s modality;Procedure related complications: intravascular or intrathecal local anesthetic injection, dural puncture, hematoma, cord injury, pneumothorax, vasovagal reaction;Location of epidural catheter tip;Dye spread (contrast dispersion);Skin to epidural distance (cm) ;Dermatomes;Procedural pain (assessed by a numeric rating scale (0 ~ 10));Patient satisfaction by global perceived effects on a 7-point scale (1 ~ 7) | — |
Countries
Korea, Republic of
Contacts
Public ContactHyun-Jung Kwon
Asan Medical Center
Outcome results
None listed