Does Ultrasound Guidance Improve Time to Perform a Spinal or Number of Attempts in Obese Patients?

NCT ID: NCT01680913

Last Updated: 2016-11-15

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

NA

Total Enrollment

67 participants

Study Classification

INTERVENTIONAL

Study Start Date

2013-01-31

Study Completion Date

2013-12-31

Brief Summary

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Spinal anesthesia depends on being able to locate physical landmarks on a patient's body. In obese patients, the commonly used landmarks may be difficult or even impossible to feel. In addition, the spine can be hidden beneath a layer of fatty tissue.

Ultrasound is useful for finding the correct injection site in pregnant patients, but the usefulness of ultrasound has not been adequately evaluated in non-pregnant patients. The potential benefits for obese patients from the use of ultrasound include shortening the duration of the procedure, increasing patient comfort, decreasing the total number of attempts, and aiding in the choice of appropriate needle length for the patient.

The investigators hypothesize that there is no difference in time to perform a spinal anesthetic when landmarking with ultrasound as compared to tactile landmarking in patients with BMI \> 35.

Detailed Description

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Conditions

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Spinal Anesthesia Administration

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

SUPPORTIVE_CARE

Blinding Strategy

NONE

Study Groups

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Spinal with ultrasound guidance

The intervention group's interspaces will be determined using the curved linear probe on a Zonare ultrasound using two views.

Group Type EXPERIMENTAL

Ultrasound guidance

Intervention Type PROCEDURE

The intervention group's interspaces will be determined using the curved linear probe on a Zonare ultrasound using two views.

Spinal anesthetic

Intervention Type PROCEDURE

Subcutaneous local infiltration with a 25g needle we be performed prior to the spinal. Neuraxial technique will be attempted midline with a 25 gauge whitacre needle in the sitting position. Spinals will be attempted on either L2-L3, L3-L4, L4-L5 interspaces. The amount and type of local anesthetic/intrathecal narcotic will be left to the discretion of the Anesthetist.

Spinal by palpation of Tuffier's line

Current clinical practice. Standard of care would have the attending anesthetist palpate the Tuffier's line to pinpoint the appropriate location for the spinal.

Group Type ACTIVE_COMPARATOR

Palpation of Tuffier's line

Intervention Type PROCEDURE

Current clinical practice. Standard of care would have the attending anesthetist palpate the Tuffier's line to pinpoint the appropriate location for the spinal.

Spinal anesthetic

Intervention Type PROCEDURE

Subcutaneous local infiltration with a 25g needle we be performed prior to the spinal. Neuraxial technique will be attempted midline with a 25 gauge whitacre needle in the sitting position. Spinals will be attempted on either L2-L3, L3-L4, L4-L5 interspaces. The amount and type of local anesthetic/intrathecal narcotic will be left to the discretion of the Anesthetist.

Interventions

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Ultrasound guidance

The intervention group's interspaces will be determined using the curved linear probe on a Zonare ultrasound using two views.

Intervention Type PROCEDURE

Palpation of Tuffier's line

Current clinical practice. Standard of care would have the attending anesthetist palpate the Tuffier's line to pinpoint the appropriate location for the spinal.

Intervention Type PROCEDURE

Spinal anesthetic

Subcutaneous local infiltration with a 25g needle we be performed prior to the spinal. Neuraxial technique will be attempted midline with a 25 gauge whitacre needle in the sitting position. Spinals will be attempted on either L2-L3, L3-L4, L4-L5 interspaces. The amount and type of local anesthetic/intrathecal narcotic will be left to the discretion of the Anesthetist.

Intervention Type PROCEDURE

Eligibility Criteria

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Inclusion Criteria

* Patients undergoing surgeries amenable to spinal anesthetic
* BMI \>35
* between the ages of 18-85

Exclusion Criteria

* Patients with known spinal disease or previous spinal surgery
* Pregnant patients
* Patients requiring emergent surgeries
* Patients in positions other than sitting during neuroaxial anesthesia
* Patients with contraindications to neuroaxial anesthesia
Minimum Eligible Age

18 Years

Maximum Eligible Age

85 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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University of Saskatchewan

OTHER

Sponsor Role lead

Responsible Party

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Jacelyn Larson

Faculty

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Jacelyn Larson, MD FRCP

Role: PRINCIPAL_INVESTIGATOR

University of Saskatchewan

Locations

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Saskatoon City Hospital

Saskatoon, Saskatchewan, Canada

Site Status

Saint Paul's Hospital

Saskatoon, Saskatchewan, Canada

Site Status

Countries

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Canada

Other Identifiers

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U/S spinals

Identifier Type: -

Identifier Source: org_study_id