Electrical Epidural Stimulation Test for Detecting Epidural Catheter Reactivation in Obstetric Population

Anesthesia, Local Clinical Trial

Official title:

Electrical Epidural Stimulation Test for Detecting Epidural Catheter Reactivation in Obstetric Population

Clinical Trial Details — Status: Not yet recruiting

Administrative data

• NCT number: NCT04983511
• Other study ID #: 61999
• Status: Not yet recruiting
• Phase: N/A
• Start date: June 2024
• Est. completion date: December 2024

Study information

• Verified date: September 2023
• Source: Stanford University
• Contact: Ban C.H. Tsui, MD
• Phone: (650) 200-9107
• Email: bantsui[@]stanford.edu
• Is FDA regulated: No
• Study type: Interventional

Clinical Trial Summary

Following labor, epidural or combined spinal-epidural (CSE) catheters are kept in place and deactivated. However, many women opt for procedures such as tubal ligation, which may require epidural anesthesia as a method of pain relief. Our study aims to confirm the ability to predict reactivation of epidural catheter in postpartum females through the electrical epidural stimulation test (EST) which was first described by the PI of this study approximately 20 years ago.

Description:

In this study, investigators hope to investigate the ability of the electrical epidural stimulation test (EST) to predict reactivation of epidural catheter in postpartum females. The standard practice for confirming the reactivation of epidural or CSE catheters requires methods such as dosing the local anesthetic. With the EST test this will allow for the anesthesiologist to determine whether or not the epidural can be activated immediately.

Recruitment information / eligibility

• Status: Not yet recruiting
• Enrollment: 40
• Est. completion date: December 2024
• Est. primary completion date: December 2024
• Accepts healthy volunteers: No
• Gender: Female
• Age group: 18 Years and older

Eligibility

Inclusion Criteria:

• Females, 18 years and older

• American Society of Anesthesiologists physical status I or II

• Status post natural labor/birth process or C-section

• Has epidural or CSE catheter

• Upcoming procedure requiring epidural/CSE anesthesia for pain management

Exclusion Criteria:

• Contraindication to regional anesthesia

• Allergy or hypersensitivity to lidocaine, bupivacaine, or fentanyl

• Use of sedatives or opioids

• Abnormal vertebrae anatomy

• Neurological disorder with lumbar involvement

• Implanted electronic devices

• Did not receive epidural or CSE anesthesia

Related Conditions & MeSH terms

• Anesthesia, Local
• Labor Pain
• Obstetric Pain

Intervention

Diagnostic Test:
• Electrical Epidural Stimulation Test (EST)
EST measures sensory/motor responses

Locations

Country	Name	City	State
n/a

Sponsors (1)

Lead Sponsor	Collaborator
Stanford University

References & Publications (3)

Carvalho JC, Khemka R, Loke J, Tsui BC. Low-dose intrathecal local anesthetic does not increase the threshold current for the epidural stimulation test: a prospective observational trial of neuraxial analgesia in labouring women. Can J Anaesth. 2015 Mar;6 — View Citation

Delgado C, Van Cleve W, Kent C, Dinges E, Bollag LA. Neuraxial anesthesia for postpartum tubal ligation at an academic medical center. F1000Res. 2018 Sep 26;7:1557. doi: 10.12688/f1000research.16025.1. eCollection 2018. — View Citation

Tsui BC, Gupta S, Finucane B. Confirmation of epidural catheter placement using nerve stimulation. Can J Anaesth. 1998 Jul;45(7):640-4. doi: 10.1007/BF03012093. — View Citation

Outcome

Type	Measure	Description	Time frame	Safety issue
Primary	Electrical Epidural Stimulation Test	Investigate the ability of the electrical epidural stimulation test (EST) to predict epidural catheter reactivation.	Duration of EST test (approximately 1-2 hours)