Analgesia, Obstetrical Clinical Trial
Official title:
Intrapartum Epidural Catheter Displacement: Comparison of Three Dressing Methods in Morbidly Obese Parturients
Failure of labor epidural is a well-recognized situation in obstetric anesthesia practice.
Incidence of epidural failure was shown to be 12% in a retrospective analysis of 19,259
deliveries. Epidural migration has been documented in both the obstetric and non-obstetric
settings. It has been argued that prevention of epidural displacement is a potential remedy
to at least part of the incomplete or failed epidurals in obstetrics.
Purpose: The investigators propose this study to prospectively evaluate the efficacy of the
three types of epidural catheter dressings that are currently in use in clinical practice, in
terms of catheter migration, taking into consideration the influence of body mass index on
this variable.
Primary aim: The investigators will evaluate the efficacy of three different epidural
catheter dressing systems in laboring patients.
Secondary aims: To compare the effect of different degrees of obesity measured by BMI, on
epidural catheter migration and quality and failure of epidural labor analgesia. To evaluate
the effect of time an indwelling catheter remains in place, level of insertion and patient's
height on epidural catheter migration.
Hypothesis: The use of dressing with transparent TegadermTM plus catheter support pad
dressing is superior to the dressing with TegadermTM plus Steri-StripTM bands, and to a
dressing with TegadermTM only, for epidural catheter fixation in laboring obese and morbidly
obese patients, in terms of catheter migration. epidural quality and failure and epidural
catheter replacement in the labor analgesia setting.
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