Anesthesia, Epidural; Anesthesia, Headache, Safety Issues
Conditions
Keywords
technique, epidural, predictors, placement
Brief summary
Epidural placement is a commonly used procedure for pain management during labor, delivery, and surgeries. However, epidural placement is often considered a technically challenging and complex procedure that requires a high level of skill and experience. In cases where the epidural is improperly placed or fails to produce effective analgesia, the discomfort and distress experienced by the patient may be heightened. Hence, the use of predictors, such as sonographic ones, may prove to be a valuable tool for healthcare professionals in the placement of epidurals, ultimately ensuring successful pain management for patients. The present study aims to identify predictors of difficult epidural placement in patients undergoing surgery.
Interventions
OTHERData collection
Several data will be collected such as: Age, weight, height, gender, previous spine surgery, skoliosis (Y/N), palpable spinous process (Y/N), experience in years of anesthesiologist, spine level of epidural placement and the following sonographic parameters at the level of epidural placement: skin-spinous process distance (cm), skin-transversous process distance (cm), erector spinae plane distance (cm), superior to inferior spinous process distance (cm)
Sponsors
University of Padova
Study design
Observational model
COHORT
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Surgery with epidural placement * Age \> 18 years
Exclusion criteria
* patient refusal
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Incidence of difficult epidural placement | through study completion, an average of 2 year | Described as the requirement to replace the needle by fully removing it from the skin. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Age (years) as predictive parameter for difficult epidural placement | through study completion, an average of 2 year | Age (years) as predictive parameter for difficult epidural placement |
| Height (cm) as predictive parameter for difficult epidural placement | through study completion, an average of 2 year | Height (cm) as predictive parameter for difficult epidural placement |
| Palpable spinous process (well, not well, not palpable) as predictive parameter for difficult epidural placement | through study completion, an average of 2 year | Palpable spinous process (well, not well, not palpable) as predictive parameter for difficult epidural placement |
| Previous spine surgery (yes, no) as predictive parameter for difficult epidural placement | through study completion, an average of 2 year | Previous spine surgery (yes, no) as predictive parameter for difficult epidural placement |
| Total body weight (kg) as predictive parameter for difficult epidural placement | through study completion, an average of 2 year | Total body weight (kg) as predictive parameter for difficult epidural placement |
| Sonographic skin to spinous process distance(cm) as predictive parameter for difficult epidural placement | through study completion, an average of 2 year | Sonographic skin to spinous process distance (cm) as predictive parameter for difficult epidural placement |
| Sonographic spinous process to spinous process distance (cm)as predictive parameter for difficult epidural placement | through study completion, an average of 2 year | Sonographic spinous process to spinous process distance (cm)as predictive parameter for difficult epidural placement |
| Sonographic skin to transverse process distance (cm) as predictive parameter for difficult epidural placement | through study completion, an average of 2 year | Sonographic skin to transverse process distance (cm) as predictive parameter for difficult epidural placement |
| Sonographic erector spine muscle group size (cm) as predictive parameter for difficult epidural placement | through study completion, an average of 2 year | Sonographic erector spine muscle group size (cm) as predictive parameter for difficult epidural placement |
| Anesthesiology experience (years) as predictive parameter for difficult epidural placement | through study completion, an average of 2 year | Anesthesiology experience (years) as predictive parameter for difficult epidural placement |
Countries
Italy
Outcome results
None listed