The Ultrasound Guided Versus Land-mark Location Method for Performing Spinal Anesthesia in Obese Parturients

Karaman Training and Research Hospital

Status: Completed

Conditions: Morbid Obesity

Treatments: Procedure: Landmark group; Procedure: Ultrasound group

Study type: Interventional

Funder types: Other

Identifiers

NCT05342922

02-2022/02

Details and patient eligibility

About

This study will be investigated whether an ultrasound-assisted technique is better than a classical land-mark technique to facilitate spinal anesthesia in the lateral position in morbidly obese pregnant women with BMI ≥ 40 who will undergo elective cesarean section.

The primary objective in this study is the rate of successful dural puncture at the first attempt. It was assumed that ultrasound could facilitate neuraxial blockade in grade 3 morbidly obese pregnant women according to the Who classification, whose topographic anatomy is difficult.

Full description

Spinal anesthesia is the most commonly used anesthesia method for elective cesarean deliveries. Anesthesiologists may have difficulties in determining the poorly palpable surface landmarks in morbidly obese pregnant women.

Manual palpation technique, which is preferred in neuraxial anesthesia, may be difficult in obese pregnant women due to the difficulty in identifying bone landmarks. Neuraxial ultrasound examination before spinal anesthesia may help spinal anesthesia performance and decrease number of attempts in obese parturients.

This study will be conducted as a single-center, prospective, randomized, double-blinded trial in a university hospital. Patients scheduled for elective cesarean will be screened for enrollment in the study. Patient, the anesthetist administering spinal anesthesia and evaluating the data were blind to the distribution of patient groups.Ultrasonographic examinations were performed by a single investigator trained in this technique who performed more than 150 ultrasound-guided neuraxial blocks.

Enrollment: 80 patients

Sex: Female

Ages: 18 to 45 years old

Volunteers: Accepts Healthy Volunteers

Inclusion criteria

• Parturient who will receive selective cesarean delivery under spinal anesthesia
• ASA 2-3 scheduled for elective sections
• BMI≥40 kg/m2
• normal singleton pregnancy
• ≥37 weeks of gestation

Exclusion criteria

• Multiple gestations
• Emergency C-section
• exist contraindications of spinal anesthesia
• Local anesthetics allergy
• BMI<40 kg/m2
• history of lumbar spinal diseases and lumbar surgery
• Parturient refusal

Trial design

Primary purpose: Treatment

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: Triple Blind

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80 participants in 2 patient groups

Ultrasound group

Active Comparator group

Description:

Ultrasound assited technique will be used for spinal anesthesia performance.

Treatment:

Procedure: Ultrasound group

Landmark group

Experimental group

Description:

Land-mark assisted technique will be used for spinal anesthesia performance.

Treatment:

Procedure: Landmark group