Assessment of Catheter Flow Direction Using Color Flow Doppler in Labor Epidurals

Samuel Lunenfeld Research Institute, Mount Sinai Hospital

Status: Completed

Conditions: Labor Pain

Treatments: Device: color flow Doppler ultrasonography

Study type: Observational

Funder types: Other

Identifiers

NCT05126745

21-07

Details and patient eligibility

About

Epidural analgesia is commonly used for pain relief in labor and involves placement of a catheter in the epidural space. Failure of epidural analgesia may occur in 12-16% of epidural catheter placements. It is defined as inadequate analgesia after the local anesthetic loading dose, despite use of appropriate dose/concentration of local anesthetic. Failure to provide adequate epidural analgesia is commonly caused by malposition of the epidural catheter. Many factors may influence the position of the tip of the epidural catheter and the resulting spread of local anesthetic into the epidural space, and consequently the quality of analgesia. Previously, X-ray exposure was required to assess catheter position in the epidural space. Recent developments have allowed the anesthesiologist to assess the catheter position at the bedside after its placement, using color flow Doppler ultrasonography.

The investigators will perform an observational study to determine epidural catheter flow direction in the obstetrical population using color flow Doppler ultrasound. Women who have delivered under epidural analgesia, either vaginal or caesarean delivery, will be approached for the study before the epidural catheter is removed.

The investigators aim to determine epidural flow relative to the insertion site, describe the findings and to correlate them with other clinical outcomes.

Enrollment: 45 patients

Sex: Female

Ages: 18 to 55 years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• Women who have delivered under epidural analgesia
• Women who have vaginal or caesarean delivery
• Women with the epidural catheter still in place

Exclusion criteria

-Women who experience fetal or maternal complications during delivery

Trial design

45 participants in 1 patient group

Patients who had an epidural placed for labour

Description:

Patients who had an epidural placed for labour may take part. Study procedures will take place after delivery and prior to removal of the epidural catheter.

Treatment:

Device: color flow Doppler ultrasonography