Pregnancy
Conditions
Keywords
Obstetric, Analgesia, Anesthesia, Obstetric Anesthesia, Obstetric Analgesia, ultrasound, ultrasonography, epidural analgesia, epidural anesthesia, spinal anesthesia, neuraxial anesthesia, neuraxial analgesia, pregnancy, labor, cesarean delivery, cesarean section
Brief summary
This is a data base building project on the use of pre-procedure ultrasound for the performance of labor epidural pain relief and spinal anesthesia for cesarean deliveries. Data collection includes ultrasound measured depth, actual needle depth, angle of ultrasound probe, actual needle angle, success rates, patient height and weight, number of attempts needed to place the epidural needle or spinal needle. Currently we are looking at the agreement between ultrasound determined depth of the epidural space or intrathecal space with actual needle depth.
Detailed description
All patients presenting in labor or are having a cesarean delivery are eligible except: patients who are under age 18, have contraindications to regional anesthesia, in advanced labor, having emergency conditions and/or unable to understand the consent process. * Data collected include: * Ultrasound depth in transverse and oblique sagittal views * Actual needle depth * Level of placement * Number of separate needle placements * Number of needle redirects * Angle of probe * Angle of needle * Total number of attempts * Pt height * Pt weight * Pt BMI * Pt age * Pt gravity/parity * Pt co-morbidities, e.g. pre-eclampsia * Procedure performed * Operator (Attending, CA-1, CA-2, CA-3, CRNA) What is currently being examined is the correlation between ultrasound depth of the target area vs actual needle depth
Interventions
DEVICEUltrasound
Preprocedure ultrasound examination of the spine
Sponsors
University of Missouri-Columbia
Study design
Observational model
COHORT
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
FEMALE
Age
18 Years to 55 Years
Healthy volunteers
Yes
Inclusion criteria
* Pregnant women in labor or scheduled for induction requesting labor epidural analgesia * Pregnant women scheduled for cesarean delivery * Pregnant women in labor who are going to have a non-emergent cesarean delivery under spinal anesthesia
Exclusion criteria
* Emergency delivery * Emergency cesarean section * Advanced labor * Contraindications to neuraxial analgesia/anesthesia * Unable to understand consent * Under the age of 18
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Correlation of Ultrasound vs Needle Depth | Beginning of ultrasound exam to end of ultrasound exam: average 5 min | The ultrasound measured depth taken via oblique sagittal views and transverse views of the epidural space for epidural analgesia or intrathecal space for spinal anesthesia will be correlated with actual needle depth |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Attempt Number | Beginning of placement of epidural or spinal needle to end of placement: average 10 min | The number of needle placement attemtps: an attempt is defined as a separate needle placement The number of needle redirects: a redirect is defined at the need for changing the angle of needle direction at each separate needle attempt |
Countries
United States
Outcome results
None listed