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Clinical Trial Details — Status: Completed

Administrative data

NCT number NCT01680913
Other study ID # U/S spinals
Secondary ID
Status Completed
Phase N/A
First received August 28, 2012
Last updated November 10, 2016
Start date January 2013
Est. completion date December 2013

Study information

Verified date November 2016
Source University of Saskatchewan
Contact n/a
Is FDA regulated No
Health authority Canada: Ethics Review Committee
Study type Interventional

Clinical Trial Summary

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.


Recruitment information / eligibility

Status Completed
Enrollment 67
Est. completion date December 2013
Est. primary completion date December 2013
Accepts healthy volunteers No
Gender Both
Age group 18 Years to 85 Years
Eligibility 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

Study Design

Allocation: Randomized, Intervention Model: Parallel Assignment, Masking: Open Label, Primary Purpose: Supportive Care


Related Conditions & MeSH terms


Intervention

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

Locations

Country Name City State
Canada Saint Paul's Hospital Saskatoon Saskatchewan
Canada Saskatoon City Hospital Saskatoon Saskatchewan

Sponsors (1)

Lead Sponsor Collaborator
University of Saskatchewan

Country where clinical trial is conducted

Canada, 

Outcome

Type Measure Description Time frame Safety issue
Primary Total time to perform the spinal From the beginning of palpation or ultrasound to free flow of Cerebral Spinal Fluid (CSF), up to 1 hour. No
Secondary Time from administration of the local anesthetic needle until free flow CSF Up to 1 hour No
Secondary Number of needle redirections At time of spinal anesthetic administration No
Secondary Number of attempts to complete the spinal As measured by new needle puncture sites, according to the anesthetist performing the procedure At time of spinal anesthetic administration No
Secondary Number of failed blocks Defined as unable to get free flow CSF or inadequate surgical block after administration of neuraxial anesthetic after 15 minutes. Up to 15 minutes after administration of spinal anesthesia No