Transesophageal Echocardiography (TEE) to Guide and Confirm Epidural Catheters in Pediatric Patients
調査の概要
詳細な説明
The aim of this study is to assess whether transesophageal echocardiography (TEE) can be used to successfully guide an epidural catheter to a targeted thoracic level in pediatric patients. The catheter will be placed in the epidural space under real-time TEE imaging and assistance by a trained TEE operator.
The primary outcome is to determine the success rate achieved using TEE guidance to thread an epidural catheter to a targeted thoracic spinal level. Post-operative radiograph will be used to confirm catheter position.
The secondary outcomes include analysis of catheter tip position within the epidural space as anterior, lateral or inferior to the spinal cord. Further, efficacy of the catheter will be determined using the following criteria from previous studies: Hemodynamic response at skin incision analyzed by heart rate and systemic blood pressure changes using the no change in HR or BP or changes < 20% from baseline were considered "sufficient block" to surgical stimulation, while HR or BP changes > 20% from baseline were considered "not sufficient block" to surgical stimulation.
研究の種類
入学 (実際)
連絡先と場所
研究場所
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Iowa
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Iowa City、Iowa、アメリカ、52242
- University of Iowa Hosptials and Clinics
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参加基準
適格基準
就学可能な年齢
健康ボランティアの受け入れ
受講資格のある性別
サンプリング方法
調査対象母集団
説明
Inclusion Criteria:
- pediatric patients scheduled to undergo cardiothoracic surgery or interventional cardiology diagnostic procedures under general anesthesia. All subjects will also be scheduled to undergo post-operative chest x-ray as a routine part of their clinical care, so no additional exposure to ionizing radiation will occur due to this study.
Exclusion Criteria:
- patients with known esophageal abnormalities, lesions or disease that would disqualify the patient for the use of TEE as standard procedure. We will further exclude any patients that are solely undergoing TEE diagnostic procedures and only include patients that are already scheduled to undergo procedures where TEE is used as part of routine surgical preparation.
研究計画
研究はどのように設計されていますか？
デザインの詳細
コホートと介入
グループ/コホート |
介入・治療 |
|---|---|
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TEE
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Epidural catheter will be placed under guidance of transesophageal echography in specific thoracic spinal segment.
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この研究は何を測定していますか？
主要な結果の測定
結果測定 |
メジャーの説明 |
時間枠 |
|---|---|---|
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Number of Participants With Successful Epidural Catheter Placement
時間枠：within one day
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The success rate achieved using TEE guidance to thread an epidural catheter to within one targeted thoracic spinal level.
Post-operative radiograph will be used to confirm catheter position.
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within one day
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協力者と研究者
スポンサー
捜査官
- 主任研究者：Kenichi Ueda, MD、University of Iowa
出版物と役立つリンク
一般刊行物
- Tsui BC, Berde CB. Caudal analgesia and anesthesia techniques in children. Curr Opin Anaesthesiol. 2005 Jun;18(3):283-8. doi: 10.1097/01.aco.0000169236.91185.5b.
- Willschke H, Marhofer P, Bosenberg A, Johnston S, Wanzel O, Sitzwohl C, Kettner S, Kapral S. Epidural catheter placement in children: comparing a novel approach using ultrasound guidance and a standard loss-of-resistance technique. Br J Anaesth. 2006 Aug;97(2):200-7. doi: 10.1093/bja/ael121. Epub 2006 May 23.
- Hassan SZ. Caudal anesthesia in infants. Anesth Analg. 1977 Sep-Oct;56(5):686-9. doi: 10.1213/00000539-197709000-00016.
- Valairucha S, Seefelder C, Houck CS. Thoracic epidural catheters placed by the caudal route in infants: the importance of radiographic confirmation. Paediatr Anaesth. 2002 Jun;12(5):424-8. doi: 10.1046/j.1460-9592.2002.00884.x.
- Blanco D, Llamazares J, Rincon R, Ortiz M, Vidal F. Thoracic epidural anesthesia via the lumbar approach in infants and children. Anesthesiology. 1996 Jun;84(6):1312-6. doi: 10.1097/00000542-199606000-00006.
- Baidya DK, Pawar DK, Dehran M, Gupta AK. Advancement of epidural catheter from lumbar to thoracic space in children: Comparison between 18G and 23G catheters. J Anaesthesiol Clin Pharmacol. 2012 Jan;28(1):21-7. doi: 10.4103/0970-9185.92429.
- Chawathe MS, Jones RM, Gildersleve CD, Harrison SK, Morris SJ, Eickmann C. Detection of epidural catheters with ultrasound in children. Paediatr Anaesth. 2003 Oct;13(8):681-4. doi: 10.1046/j.1460-9592.2003.01151.x.
- Tsui BC, Seal R, Koller J. Thoracic epidural catheter placement via the caudal approach in infants by using electrocardiographic guidance. Anesth Analg. 2002 Aug;95(2):326-30, table of contents. doi: 10.1097/00000539-200208000-00016.
- Tsui BC, Tarkkila P, Gupta S, Kearney R. Confirmation of caudal needle placement using nerve stimulation. Anesthesiology. 1999 Aug;91(2):374-8. doi: 10.1097/00000542-199908000-00010.
- Rapp HJ, Folger A, Grau T. Ultrasound-guided epidural catheter insertion in children. Anesth Analg. 2005 Aug;101(2):333-339. doi: 10.1213/01.ANE.0000156579.11254.D1.
- Roberts SA, Galvez I. Ultrasound assessment of caudal catheter position in infants. Paediatr Anaesth. 2005 May;15(5):429-32. doi: 10.1111/j.1460-9592.2004.01512.x.
- Owall A, Stahl L, Settergren G. Incidence of sore throat and patient complaints after intraoperative transesophageal echocardiography during cardiac surgery. J Cardiothorac Vasc Anesth. 1992 Feb;6(1):15-6. doi: 10.1016/1053-0770(91)90037-t.
研究記録日
主要日程の研究
研究開始
一次修了 (実際)
研究の完了 (実際)
試験登録日
最初に提出
QC基準を満たした最初の提出物
最初の投稿 (見積もり)
学習記録の更新
投稿された最後の更新 (実際)
QC基準を満たした最後の更新が送信されました
最終確認日
詳しくは
本研究に関する用語
キーワード
その他の研究ID番号
- 201207769
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