Assessment of Catheter Flow Direction Using Color Flow Doppler in Labor Epidurals
Assessment of Catheter Flow Direction Using Color Flow Doppler in Labor Epidurals: an Observational Study
Epidural analgesia is commonly used for pain relief in labor and involves placement of a catheter in the epidural space. Failure of epidural analgesia may occur in 12-16% of epidural catheter placements. It is defined as inadequate analgesia after the local anesthetic loading dose, despite use of appropriate dose/concentration of local anesthetic. Failure to provide adequate epidural analgesia is commonly caused by malposition of the epidural catheter. Many factors may influence the position of the tip of the epidural catheter and the resulting spread of local anesthetic into the epidural space, and consequently the quality of analgesia. Previously, X-ray exposure was required to assess catheter position in the epidural space. Recent developments have allowed the anesthesiologist to assess the catheter position at the bedside after its placement, using color flow Doppler ultrasonography.
The investigators will perform an observational study to determine epidural catheter flow direction in the obstetrical population using color flow Doppler ultrasound. Women who have delivered under epidural analgesia, either vaginal or caesarean delivery, will be approached for the study before the epidural catheter is removed.
The investigators aim to determine epidural flow relative to the insertion site, describe the findings and to correlate them with other clinical outcomes.
調査の概要
研究の種類
入学 (実際)
連絡先と場所
研究場所
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Ontario
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Toronto、Ontario、カナダ、M5G1X5
- Mount Sinai Hospital
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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:
- Women who have delivered under epidural analgesia
- Women who have vaginal or caesarean delivery
- Women with the epidural catheter still in place
Exclusion Criteria:
-Women who experience fetal or maternal complications during delivery
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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分娩時に硬膜外麻酔を受けた患者
陣痛のために硬膜外麻酔を受けた患者は、参加することができます。
研究手順は、送達後、硬膜外カテーテルの除去前に行われます。
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Doppler ultrasonography
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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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Visualization of flow relative to the interspace insertion level as assessed by color flow Doppler ultrasound
時間枠：15 min
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Visualization of flow relative to the interspace insertion level as assessed by color flow Doppler ultrasound (at insertion level [yes/no], above insertion level [yes/no], below insertion level [yes/no], no visualization of flow in any space).
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15 min
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二次結果の測定
結果測定 |
メジャーの説明 |
時間枠 |
|---|---|---|
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Level of epidural catheter insertion: questionnaire
時間枠：5 min
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The anesthesiologist will record the intervertebral level at which the epidural was placed: L2-L3, L3-L4
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5 min
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Epidural regimen: questionnaire
時間枠：5 min
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Settings for the epidural pump as charted by the anesthesiologist and the nurse.
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5 min
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Maximum upper sensory block to ice: questionnaire
時間枠：5 min
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Maximum upper sensory block to ice as charted by the nurse in the electronic charting system
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5 min
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Any anesthetic intervention for patchy or asymmetric block
時間枠：5 min
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The anesthetic record will be reviewed for any interventions done.
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5 min
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Number of manual epidural top ups
時間枠：5 min
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The number of top ups given by nurses or physicians manually will be recorded from the chart.
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5 min
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Number of PCEA (patient controlled epidural analgesia) boluses delivered
時間枠：5 min
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Number of PCEA (patient controlled epidural analgesia) boluses delivered will be collected from the chart.
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5 min
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Duration of epidural analgesia
時間枠：5 min
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Time of epidural placement to delivery or placement to top up for caesarean delivery.
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5 min
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Quality of analgesia questionnaire - 1st stage
時間枠：5 min
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Quality of analgesia during first stage as defined by the patient on a VNRS (verbal numerical rating scale) 0-10 : On a scale from 0-10 (where 0 is not at all and 10 is the best ever), how well did your epidural work from the start of your epidural until you were fully dilated? |
5 min
|
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Quality of analgesia questionnaire - 2nd stage
時間枠：5 min
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Quality of analgesia during second stage as defined by the patient on a VNRS (verbal numerical rating scale) 0-10: On a scale from 0-10 (where 0 is not at all and 10 is the best ever), how well did your epidural work from you were fully dilated until the delivery of your baby? |
5 min
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協力者と研究者
出版物と役立つリンク
研究記録日
主要日程の研究
研究開始 (実際)
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 (実際)
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
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