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The aim of this study is to demonstrate the feasibility of a new technique using real time ultrasound guided paramedian approach to the epidural space. This approach will use transverse view of the spine utilizing curvilinear low frequency ultrasound probe "Sonosite S nerve" and echogenic 17G tuohy needles " Pajunk TuohySono"
The investigators believe that this new technique is helpful to get the best anatomic landmark for epidural catheter placement using the real-time ultrasound.
Measurable outcomes:
Block success rate will be measured as the rate of cases that will have successful insertion of the epidural catheter using ultrasound guidance and the case is done completely under epidural anesthesia.
All cases that will be converted to general anesthesia will be counted unsuccessful.
Other measurable outcome data that will be collected will include needle depth to the epidural space, and ultrasound measured depth to the lamina
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| echogenic 17G tuohy needles " Pajunk TuohySono | Experimental | Epidural will be placed with the aid of ultrasound and echogenic 17G Tuohy needles (Pajunk TuohySono). |
|
| standard epidural needles | Placebo Comparator | Epidural will be placed in standard practice with standard needles. |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| epidural needle placement with echogenic 17G Tuohy needles (Pajunk TuohySono) | Other | Anesthesiologist will place epidural with aid of ultrasound and placement with echogenic 17G Tuohy needles (Pajunk TuohySono) |
| Measure | Description | Time Frame |
|---|---|---|
| Real-time ultrasound-guided paramedian epidural access: | Block success rate will be measured as the rate of cases that will have succesful insertion of the epidural catheter using ultrasound guidance and the case is done completely under epidural anesthesia. The aim of this study is to demonstrate the feasibility of a new technique using real time ultrasound guided paramedian approach to the epidural space. This approach will use transverse view of the spine utilizing curvilinear low frequency ultrasound probe "Sonosite S nerve" and echogenic 17G tuohy needles " Pajunk TuohySono" | Day 1 |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Sherif Zaky, M.D. | The Cleveland Clinic | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Cleveland Clinic | Cleveland | Ohio | 44195 | United States |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 30865772 | Derived | Elsharkawy H, Saasouh W, Babazade R, Soliman LM, Horn JL, Zaky S. Real-time Ultrasound-Guided Lumbar Epidural with Transverse Interlaminar View: Evaluation of an In-Plane Technique. Pain Med. 2019 Sep 1;20(9):1750-1755. doi: 10.1093/pm/pnz026. |
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| standard epidural placement | Other | Anesthesiologist will place epidural within standard practice, with standard needles. |
|