Evaluation of Ultrasound (US) Assistance for Anesthesia Trainees for Caesarean Section Spinal Placement

London Health Sciences Centre Research Institute OR Lawson Research Institute of St. Joseph's80 enrolled

Overview

Parturients receiving spinal anesthetic for Cesarean section will be randomized to have/not have pre-spinal ultrasound examination of their back.

Parturients receiving spinal anesthetic for elective Cesarean section will be randomized to have/not have pre-spinal ultrasound examination of their back, prior to spinal insertion by anesthesia trainees. The hypothesis is that ultrasound visualization of the patient spinal spaces will allow junior residents to correctly place the spinal needle with fewer attempts. The null hypothesis is that there is no difference in the primary outcome (number of attempts). i.e. the investigators hypothesize that the number of attempts is not affected by ultrasound assistance. The control group will undergo spinal anesthesia with manual palpation, the standard of care.

Study Type

INTERVENTIONAL

Allocation

RANDOMIZED

Masking

SINGLE

Enrollment

Conditions

Pregnancy

Interventions

Ultrasound examinationDEVICE

Trainees will receive pre-procedure U/S guided examination of the parturient's back.

Eligibility

Sex: FEMALEMin age: 18 YearsMax age: 45 YearsHealthy volunteers:

Medical Language ↔ Plain English

Inclusion Criteria: 1. Parturient scheduled for elective spinal anesthetic for caesarean section. 2. Resident level PGY1 or PGY2. 3. Resident experience between 2-25 spinal anesthetics. 4. ASA 1-3 scheduled for elective sections Exclusion Criteria: 1. Parturient BMI \> 40. 2. Emergency C-section. 3. Previous spinal surgery or scoliosis. 4. Parturient refusal 5. Resident refusal 6. Multiple gestations

Locations (1)

Victoria Hospital

London, Ontario, Canada

Outcomes

Primary Outcomes

Number of attempts at intrathecal needle tip placement during spinal anesthesia.

Time frame: Day 1

Secondary Outcomes

1. Time to place spinal anesthetic (seconds), measured from introducer placement to confirmation of cerebral spinal fluid (CSF).

Time frame: Day 1

Space used for 1st attempt, as estimated by palpation or U/S

Time frame: Day 1

Number of spaces used

Time frame: Day 1

Dural depth (cm)

Time frame: Day 1

Data from ClinicalTrials.gov

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