Use of Ultrasound Guidance to Assist With Labor Epidural Placement in Patients With a BMI ≥40

Thomas J. Vernon

Status: Completed

Conditions: Labor Pain

Treatments: Device: Ultrasound; Other: Palpation

Study type: Interventional

Funder types: Other

Identifiers

NCT02984267

OBUS1123

Details and patient eligibility

About

Placement of labor epidurals is a very common daily practice in obstetrical anesthesia. Currently, these epidurals are placed based upon palpation of landmarks to determine midline and the correct spinal level for placement. Palpation of these landmarks can be difficult, however, particularly in morbidly obese patients who have significant amounts of soft tissue overlying them. This study seeks to use ultrasound guidance to examine the spine prior to epidural placement, and see what effects this has compared to palpation alone with respect to procedure time, number of attempts, success rate in the first attempt, failure rate, complication rate, patient anxiety levels, and patient satisfaction levels.

Enrollment: 18 patients

Sex: Female

Ages: 18+ years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• Current (pregnant) BMI ≥ 40
• Age ≥ 18
• ASA score of 3 or less
• Full term pregnancy (37 weeks gestational age or greater)

Exclusion criteria

• Known scoliosis
• Known contraindications to neuraxial blockade
• Intrauterine fetal demise or non-viable fetus.

Trial design

Primary purpose: Treatment

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: None (Open label)

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18 participants in 2 patient groups

Ultrasound Group

Experimental group

Description:

The interventional group that will have their spine evaluated by ultrasound prior to epidural placement

Treatment:

Device: Ultrasound

Palpation Group

Other group

Description:

The control group that will have their epidural placed in the usual fashion based on palpation

Treatment:

Other: Palpation