Labor Pain, Obesity, Morbid
Conditions
Keywords
Labor Epidural
Brief summary
The goal of this clinical trial is to compare traditional palpation to pre-procedural lumbar ultrasound prior to epidural placement in obese (BMI \>40) obstetric patient population. The main questions it aims to answer are: * Is a pre-procedural lumbar ultrasound superior to traditional palpation in terms of total number of epidural needle redirections during epidural placement? * Is there no difference in time to epidural loss between pre-procedural lumbar ultrasound and traditional palpation during epidural placement? Participants will be randomized to either a pre-procedural lumbar ultrasound or traditional palpation at the time of epidural placement.
Interventions
DIAGNOSTIC_TESTLumbar Ultrasound
Investigators will utilize our ultrasound machine to complete a pre-procedural lumbar ultrasound prior to epidural placement.
Sponsors
MetroHealth Medical Center
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
SINGLE (Outcomes Assessor)
Eligibility
Sex/Gender
FEMALE
Age
18 Years to No maximum
Healthy volunteers
Yes
Inclusion criteria
* 18 years or older * English Speaking * BMI (Body Mass Index) \> 40 * Ability to provide informed consent and verbally disclose their medical history
Exclusion criteria
* History of spine surgery, scoliosis, or other spinal abnormality which could complicate epidural placement * Patients with platelet counts \<70,000 or patients who are on anticoagulation, or patients who are on anticoagulation, both would exclude any patient from receiving an epidural. * Minors * Adults unable to make their own decisions or with cognitive issues or developmental delays * Prisoners
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Epidural Redirects | Day of Epidural | Total number of epidural needle redirections |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Total time to epidural space | Day of Epidural | Total time to epidural space observed via loss of resistance. |
| Number of attempts at a different level | Day of Epidural | Number of attempts at a different lumbar level. |
| Epidural replacement rate | Day of Epidural | Includes epidurals that needed to be replaced because of failed epidural or inadequate pain relief |
| Patient satisfaction | 24 hours post-epidural | Patient's satisfaction with epidural experience observed by a survey in post-partum |
Countries
United States
Outcome results
None listed