Low current electrical stimulation test, also called the Tsui test, has been used successfully to confirm the catheter location in the epidural space in various patient populations. The results of this study will show whether or not doing a Tsui test can predict inadequate epidural analgesia early in the course of placing the epidural, so that the appropriate measures could be applied immediately upon gathering unfavorable results.
Despite its very high success rate, the epidural technique remains a rather blind technique, and failures continue to occur. The incidence and reasons for failure are not well understood. The Tsui test is not routinely performed with each epidural catheter insertion, but rather it is used when there is suspicion about the catheter location. In this study, the Tsui test will be performed twice during the epidural procedure, and bupivacaine consumption will be recorded for the first 2 hours. Information gained from this study could have great impact in clinical practice, since the incidence of inadequate labor analgesia is still relatively high (10-20%), leading to maternal distress and disappointing labor experience.
Study Type
INTERVENTIONAL
Allocation
NA
Purpose
DIAGNOSTIC
Masking
NONE
Enrollment
102
The stimulator is set at frequency of 1Hz with 200ms pulse width and the current output ranging from 0 to 20 mA. The current output will be carefully increased from zero until motor activity is detected up to a maximum of 20 mA.
Mount Sinai Hospital
Toronto, Ontario, Canada
Consumption of bupivacaine in mg/hour in the first 2 hours of epidural anesthesia
Time frame: 2 hours
Incidence of inadequate epidural block.
Time frame: 2 hours
Current (mA) needed to elicit motor response; 1. before test dose and 2. 5 minutes after test dose.
Time frame: 5 minutes
Contraction pattern elicited by the Tsui test at baseline and after test dose.
Time frame: 5 minutes
This platform is for informational purposes only and does not constitute medical advice. Always consult a qualified healthcare professional.