Neuraxial Ultrasound for Thoracic Epidural Placement

Benaroya Research Institute

Status: Completed

Conditions: Analgesia, Epidural

Treatments: Drug: Hydromorphone 0.01mg/mL; Drug: Bupivacaine 0.05%; Procedure: Thoracic Epidural Placement

Study type: Interventional

Funder types: Other

Identifiers

NCT02785055

IRB08130

Details and patient eligibility

About

This blinded, randomized study compares standard palpation to ultrasound-assisted landmark identification of the thoracic spine for thoracic epidural catheterization.

Full description

In this study, the investigators will utilize ultrasonography to identify midline bony landmarks including spinous processes, laminae, and intervertebral interspaces prior to the initial needle placement and compare this to standard palpation of the bony thoracic spine for thoracic epidural placement. The investigators will evaluate and compare the two needle localization techniques by the following outcomes: time to identify the epidural space by loss of resistance, needle passes, skin punctures, recovery room pain scores, and epidural success.

Enrollment: 70 patients

Sex: All

Ages: 18+ years old

Volunteers: Accepts Healthy Volunteers

Inclusion criteria

• American Society of Anesthesiology Classification I-IV
• thoracic surgery
• abdominal surgery

Exclusion criteria

• contraindications to epidural catheter
• pregnancy
• coagulopathy
• infection (localized)
• allergy to local anesthetics

Trial design

Primary purpose: Treatment

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: Double Blind

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70 participants in 2 patient groups

Ultrasound-Assisted

Active Comparator group

Description:

Ultrasound assisted marking of the thoracic spine on the skin for Thoracic Epidural Placement

Treatment:

Procedure: Thoracic Epidural Placement

Drug: Hydromorphone 0.01mg/mL

Drug: Bupivacaine 0.05%

Palpation

Active Comparator group

Description:

Palpation marking of the thoracic spine on the skin for Thoracic Epidural Placement

Treatment:

Procedure: Thoracic Epidural Placement

Drug: Hydromorphone 0.01mg/mL

Drug: Bupivacaine 0.05%