Determination of Utility of Intergluteal Cleft as Landmark for Neuraxial Midline in Obstetrics (CLEFT)

Guy's and St Thomas' NHS Foundation Trust

Status: Enrolling

Conditions: Obstetric Anesthesia Problems

Treatments: Diagnostic Test: Neuraxial Midline; Diagnostic Test: Intergluteal Cleft; Diagnostic Test: Horizontal Distance between Vertical Markings

Study type: Observational

Funder types: Other

Identifiers

NCT05983029

291462

Details and patient eligibility

About

Our aim is to investigate whether a novel landmark, the groove between the buttocks or the intergluteal cleft, can facilitate the identification of the neuraxial midline in obstetric patients when compared to ultrasound as the reference standard for the determination of this midline

Full description

Determine if the intergluteal cleft, when compared to ultrasound as the reference standard, can be used to identify the neuraxial midline in obstetric patients

Difference in horizontal distance between the vertical lines of the intergluteal cleft and the neuraxial midline, the latter measured with ultrasound

Enrollment: 99 estimated patients

Sex: Female

Ages: 18+ years old

Volunteers: No Healthy Volunteers

Inclusion and exclusion criteria

Inclusion criteria

• Female
• 18 years of age or older
• Gestation of 37 weeks or above

Exclusion criteria

• Acute or chronic confusional state
• Allergy to ultrasound gel
• Positive for COVID-19 and/or presence of symptoms consistent with SARS-Cov-2, such as anosmia, cough or fever
• History of previous surgery to the spine
• Scoliosis
• Unable to speak and/or understand English

Trial design

99 participants in 1 patient group

Study Group

Description:

Each patient will be requested to adopt a standardised upright position. First, two of the investigators will use a spirit level ruler and ink pen to agree upon and visibly mark the horizontal intercristal line on the back of the patient. Second, investigator B will leave the room, and investigator A will make a vertical mark with an ultraviolet pen denoting the intersection of the inferior aspect of the intergluteal cleft and the horizontal intercristal line. Third, investigator A will then leave the room, and investigator B will return to the room to make a vertical mark with an ink pen representing the intersection of the neuraxial midline, as established with the transverse spinous process view on ultrasound, and the horizontal intercristal line. After these two vertical marks have been made at the level of the intercristal line, the horizontal distance between them will be measured in mm by these same two investigators

Treatment:

Diagnostic Test: Horizontal Distance between Vertical Markings

Diagnostic Test: Intergluteal Cleft

Diagnostic Test: Neuraxial Midline