Utility of Ultrasound in Identification of Midline and Placement of Epidural in Severely Obese Parturients
| Status: | Recruiting |
|---|---|
| Conditions: | Obesity Weight Loss |
| Therapuetic Areas: | Endocrinology |
| Healthy: | No |
| Age Range: | 19 - 45 |
| Updated: | 4/17/2018 |
| Start Date: | June 22, 2015 |
| End Date: | June 2020 |
| Contact: | Alicia Kindred, MS |
| Email: | aliciakindred@uabmc.edu |
| Phone: | 205-934-4711 |
Utility of Ultrasound in Identification of Midline and Placement of Epidural in Severely Obese Parturients: A Randomized, Prospective Study
This study will address the utility of ultrasound in the placement of an epidural catheter in
severely obese parturients. Identification of midline can often be difficult using the
standard method of palpation in obese patients. The Investigator will determine if the use of
ultrasound decreases the amount of time and number of attempts required to place the
epidural.
severely obese parturients. Identification of midline can often be difficult using the
standard method of palpation in obese patients. The Investigator will determine if the use of
ultrasound decreases the amount of time and number of attempts required to place the
epidural.
The use of ultrasound has expanded into many areas of medicine including the identification
of bony landmarks to facilitate epidural placement in obstetric anesthesia. Using ultrasound
for epidural placement has become popular over the last decade with several studies being
published on the topic. The likely increase in popularity for ultrasound use in the obstetric
population is the need to more reliably locate bony landmarks as the traditional palpation
technique has been shown to be an inaccurate way to accomplish this. Given the fact that the
long-taught palpation technique can be inaccurate and studies have validated the use of
ultrasound for epidural placement, ultrasound technique is routinely taught by the obstetric
anesthesiologists to the anesthesiology residents at UAB. Also, since both techniques are
considered standard practice at UAB, anesthesia providers (residents, fellows, and faculty)
are free to choose either technique to locate bony structures of the back prior to epidural
placement. Since no current study has specifically addressed its use in the obese pregnant
patient, the investigators would like to validate its use in this population.
In this study, investigators will evaluate the use of ultrasound in the obese population to
determine if its use will decrease the time it takes to place the epidural and number of
attempts required when compared to the traditional palpation technique. The study will also
determine the success rate of epidural placement in both the palpation and ultrasound groups.
of bony landmarks to facilitate epidural placement in obstetric anesthesia. Using ultrasound
for epidural placement has become popular over the last decade with several studies being
published on the topic. The likely increase in popularity for ultrasound use in the obstetric
population is the need to more reliably locate bony landmarks as the traditional palpation
technique has been shown to be an inaccurate way to accomplish this. Given the fact that the
long-taught palpation technique can be inaccurate and studies have validated the use of
ultrasound for epidural placement, ultrasound technique is routinely taught by the obstetric
anesthesiologists to the anesthesiology residents at UAB. Also, since both techniques are
considered standard practice at UAB, anesthesia providers (residents, fellows, and faculty)
are free to choose either technique to locate bony structures of the back prior to epidural
placement. Since no current study has specifically addressed its use in the obese pregnant
patient, the investigators would like to validate its use in this population.
In this study, investigators will evaluate the use of ultrasound in the obese population to
determine if its use will decrease the time it takes to place the epidural and number of
attempts required when compared to the traditional palpation technique. The study will also
determine the success rate of epidural placement in both the palpation and ultrasound groups.
Inclusion Criteria:
- patient request for a labor epidural
- BMI≥35
Exclusion Criteria:
- BMI<35
- patient refusal of a labor epidural
- coagulopathy
- platelets<80,000
- prior spine procedure or instrumentation
- a diagnosis of scoliosis
- an intracranial or spinal mass
We found this trial at
1
site
Birmingham, Alabama 35249
Principal Investigator: Mark Powell, MD
Phone: 205-934-4711
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