Use of Ultrasound in Obstetric Neuraxial Analgesia and Anesthesia Data Base

Use of Ultrasound in Obstetric Neuraxial Analgesia and Anesthesia Data Base

This is a data base building project on the use of pre-procedure ultrasound for the performance of labor epidural pain relief and spinal anesthesia for cesarean deliveries. Data collection includes ultrasound measured depth, actual needle depth, angle of ultrasound probe, actual needle angle, success rates, patient height and weight, number of attempts needed to place the epidural needle or spinal needle. Currently we are looking at the agreement between ultrasound determined depth of the epidural space or intrathecal space with actual needle depth.

All patients presenting in labor or are having a cesarean delivery are eligible except: patients who are under age 18, have contraindications to regional anesthesia, in advanced labor, having emergency conditions and/or unable to understand the consent process.

• Data collected include:
• Ultrasound depth in transverse and oblique sagittal views
• Actual needle depth
• Level of placement
• Number of separate needle placements
• Number of needle redirects
• Angle of probe
• Angle of needle
• Total number of attempts
• Pt height
• Pt weight
• Pt BMI
• Pt age
• Pt gravity/parity
• Pt co-morbidities, e.g. pre-eclampsia
• Procedure performed
• Operator (Attending, CA-1, CA-2, CA-3, CRNA)

What is currently being examined is the correlation between ultrasound depth of the target area vs actual needle depth

Inclusion Criteria:

• Pregnant women in labor or scheduled for induction requesting labor epidural analgesia
• Pregnant women scheduled for cesarean delivery
• Pregnant women in labor who are going to have a non-emergent cesarean delivery under spinal anesthesia

Exclusion Criteria:

• Emergency delivery
• Emergency cesarean section
• Advanced labor
• Contraindications to neuraxial analgesia/anesthesia
• Unable to understand consent
• Under the age of 18