Using the CompuFlo® CathCheck™ System to Check Epidural Catheter Function Before Tubal Ligation: A Pilot Study

Assessing Labor Epidural Catheter Dysfunction for Tubal Ligation in Parturients Using CompuFlo® CathCheck™ System: A Pilot Study

This pilot study evaluates the use of the CompuFlo® CathCheck™ System to assess labor epidural catheter function before reactivation for postpartum tubal ligation. The study aims to determine whether this technology can accurately identify functional versus dysfunctional epidural catheters compared with standard clinical assessment methods. Improving catheter assessment may reduce failed epidural reactivation, the need for additional anesthesia techniques, and improve patient safety.

Study Overview

• Status: Recruiting
• Conditions: Anesthesia, Epidural
• Intervention / Treatment: Device: CompuFlo® CathCheck™ System Assessment

Detailed Description

Postpartum tubal ligation is a common surgical procedure performed after delivery, and labor epidural catheters are frequently used for anesthesia during this procedure. However, reactivation of labor epidural catheters after vaginal delivery can fail, requiring conversion to spinal or general anesthesia. Reported failure rates are significant, and factors such as prolonged time since delivery, prior need for additional epidural medication during labor, and poor analgesic satisfaction may increase the risk of failure.

Currently, there is no standardized method to confirm the continued function and location of an epidural catheter after childbirth and before reactivation for postpartum procedures. Standard clinical practice typically relies on catheter aspiration, epidural test dosing, and assessment of sensory blockade, but these methods may not reliably identify catheter dysfunction or migration.

This prospective pilot cohort study will evaluate the use of the CompuFlo® CathCheck™ System as an additional objective tool for assessing labor epidural catheter function before postpartum tubal ligation. The system uses computerized pressure measurements and pulsatile waveform detection to evaluate epidural catheter placement and patency. Study assessments will be compared with standard clinical evaluation methods to determine the ability of the device to identify functional versus dysfunctional epidural catheters.

The primary objective of this study is to assess the diagnostic accuracy of the CompuFlo® CathCheck™ System, including its sensitivity and specificity, in predicting successful epidural catheter reactivation. This study aims to determine whether incorporating objective pressure and waveform measurements can improve identification of catheter dysfunction, reduce failed epidural reactivation, minimize the need for additional anesthesia procedures, and enhance patient safety during postpartum tubal ligation.

• Study Type: Interventional
• Enrollment (Estimated): 120
• Phase: Not Applicable

Contacts and Locations

• Study Contact: Name: Ling-Qun Hu, MD; Phone Number: 6142933559; Email: LingQun.Hu@osumc.edu
• Study Contact Backup: Name: Alberto Uribe Vega; Phone Number: 6142933559; Email: alberto.uribe@osumc.edu

Study Locations

• United States
  • Ohio
    • Columbus, Ohio, United States, 43210
      • Recruiting
      • The Ohio State University

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Adult; Older Adult
• Accepts Healthy Volunteers: No

Description

Inclusion Criteria

• Age ≥ 18 years
• Postpartum women electing to undergo tubal ligation with an indwelling labor epidural catheter
• Ability to provide informed consent in English
• Vaginal delivery

Exclusion Criteria

• Parturients not receiving labor epidural analgesia or receiving an alternative anesthetic technique during labor and delivery
• Epidural catheter located >2 cm from the documented insertion depth at initial placement
• Planned elective cesarean delivery
• Chronic pain conditions (e.g., chronic low back pain, sickle cell disease)
• Chronic opioid use disorder
• Chronic gabapentin use
• Uncontrolled mood disorders that, in the investigator's judgment, may interfere with study participation or interpretation of study outcomes
• Prisoners or incarcerated individuals

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Diagnostic
• Allocation: N/A
• Interventional Model: Single Group Assignment
• Masking: None (Open Label)

Number of Arms

1

Arms and Interventions

Participant Group / Arm

Intervention / Treatment

Experimental: Labor Epidural Reactivation Cohort; Postpartum women undergoing elective tubal ligation after vaginal delivery with an indwelling labor epidural catheter. Participants will undergo standard epidural catheter assessment and reactivation, including evaluation with the CompuFlo® CathCheck™ System to determine catheter functionality and predict successful epidural anesthesia for the tubal ligation procedure.

Device: CompuFlo® CathCheck™ System Assessment; Evaluation of labor epidural catheter functionality using the CompuFlo® CathCheck™ System following standard epidural test-dose administration and prior to epidural reactivation for postpartum tubal ligation.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Rate of Successful Labor Epidural Catheter Reactivation	The percentage of participants with successful use of the existing labor epidural catheter for postpartum tubal ligation without evidence of catheter failure or the need for alternative anesthesia techniques (e.g., conversion to general anesthesia or spinal anesthesia).	Periprocedural (from the start of epidural reactivation assessment until the completion of the postpartum tubal ligation procedure)

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Sensitivity of the CompuFlo® CathCheck™ System	The sensitivity percentage of the CompuFlo® CathCheck™ System for correctly identifying functional labor epidural catheters that successfully provide anesthesia for postpartum tubal ligation.	Pre-procedural (prior to epidural reactivation)
Specificity of the CompuFlo® CathCheck™ System	The specificity percentage of the CompuFlo® CathCheck™ System for correctly identifying non-functional labor epidural catheters.	Pre-procedural (prior to epidural reactivation)
Area Under the Receiver Operating Characteristic (ROC) Curve (AUC) of the CompuFlo® CathCheck™ System	The AUC value of the CompuFlo® CathCheck™ System to evaluate its overall diagnostic performance in discriminating between functional and non-functional labor epidural catheters.	Pre-procedural (prior to epidural reactivation)
Number of Dermatomal Sensory Block Levels After Epidural Test Dose	The number of dermatomal levels demonstrating loss of cold sensation following a standard epidural local anesthetic test dose.	Periprocedural (at the time of labor epidural placement and at the time of epidural reactivation)
Duration of Labor Epidural Catheter Unused Time	The total duration of time (measured in hours) between the completion of labor analgesia and the attempted epidural reactivation for the tubal ligation.	Periprocedural (from delivery until epidural reactivation)
Frequency of Labor Epidural Top-Up Doses	The total number of supplemental epidural local anesthetic bolus doses administered during labor prior to delivery.	Intrapartum (from labor epidural placement until delivery)
Postoperative Pain Intensity via Numeric Rating Scale (NRS-11)	Pain intensity measured using the 11-point Numeric Rating Scale (NRS-11), where 0 represents "no pain" and 10 represents "the worst pain imaginable."	Periprocedural (upon admission to the post-anesthesia care unit [PACU] and at discharge from the PACU)
Patient Satisfaction Score With Labor Analgesia	Patient-reported satisfaction with labor epidural analgesia, assessed using a standard Likert scale (e.g., 1-5 scale, where 1 is "highly dissatisfied" and 5 is "highly satisfied").	Periprocedural (prior to discharge from the post-anesthesia care unit [PACU])
Patient Satisfaction Score With Tubal Ligation Anesthesia	Patient-reported satisfaction with anesthetic management during the postpartum tubal ligation procedure, assessed using a standard Likert scale (e.g., 1-5 scale, where 1 is "highly dissatisfied" and 5 is "highly satisfied").	Periprocedural (prior to discharge from the post-anesthesia care unit [PACU])

Collaborators and Investigators

• Sponsor: Ohio State University

Study record dates

Study Major Dates

• Study Start (Actual): December 19, 2024
• Primary Completion (Estimated): October 31, 2028
• Study Completion (Estimated): December 31, 2028

Study Registration Dates

• First Submitted: July 13, 2026
• First Submitted That Met QC Criteria: July 17, 2026
• First Posted (Actual): July 22, 2026

Study Record Updates

• Last Update Posted (Actual): July 22, 2026
• Last Update Submitted That Met QC Criteria: July 17, 2026
• Last Verified: July 1, 2026

More Information

Terms related to this study

• Keywords: Labor epidural catheter; Epidural catheter dysfunction; CompuFlo CathCheck System; Tubal ligation in parturients
• Other Study ID Numbers: 2023H0188

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: Yes
• product manufactured in and exported from the U.S.: No