Patients Undergoing Thoracic Surgery, Patients Undergoing Upper Abdominal Surgery
Conditions
Brief summary
In patients scheduled for thoracic surgery or upper abdominal surgery, investigators will determine the accuracy of the epidural catheter placement by using fluoroscopic imaging. Previous studies have drawn contradictory conclusions based the potential flaw assumption of 100% success rate for correct epidural catheter placement in the thoracic region.
Detailed description
Thoracic epidural analgesia (TEA) is a key tool in management of pain after thoracic or upper abdominal surgery. TEA optimizes pain relief while minimizing the use of systemic opioids, thus reducing the duration of postoperative ileus. TEA also attenuates surgical stress response and allows for early mobilization. Despite all the touted benefits of TEA, much controversy limits its use for post surgical pain due to fear of exceedingly rare, if not entirely theoretical complication of epidural hematoma. Beneficial effects of TEA require that catheter placement and infusate be targeted at the thoracic segments innervating injured skin, muscle, and bone from which pain input originates. The purpose of this study is to determine the accuracy of thoracic epidural continuous catheter insertion by using fluoroscopic imaging.
Interventions
PROCEDUREFluoroscopic imaging
Contrast media (5 mL) will be injected through the catheter and fluoroscopic images will be obtained and saved in the lateral and antero-posterior projections.
Sponsors
Chicago Anesthesia Pain Specialists
Study design
Allocation
NA
Intervention model
SINGLE_GROUP
Primary purpose
TREATMENT
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
18 Years to 80 Years
Healthy volunteers
No
Inclusion criteria
* 18- 80 years old patients * Patients undergoing thoracic surgery * Patients undergoing upper abdominal surgery
Exclusion criteria
* Severe Aortic Valve stenosis * Active Neurologic Disease * Allergy to lidocaine or bupivacaine * Allergy to iodine-based contrast * Cutaneous Disorders at epidural insertion site * Preoperative impaired coagulation status * Pregnancy
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Presumed intervertebral level of epidural catheter | During procedure | At the time of thoracic epidural catheter insertion |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Radiologic confirmation of epidural catheter placement | Post procedure within one week. | Radiology department will assess within one week after the procedure the images, to confirm the epidural catheter placement. |
| Change in Numeric Rating Pain Score from baseline | 1, 24 and 48 hrs | 1, 24, and 48 hrs after the end of the surgery. |
Other
| Measure | Time frame | Description |
|---|---|---|
| Patient satisfaction | Post procedure at 48 hours | Patient satisfaction 48 hrs after the end of surgery |
Countries
United States
Outcome results
None listed