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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.
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.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Electrical Epidural Stimulation Test (EST) | Experimental | Postpartum women are given EST to predict epidural catheter reactivation for their subsequent procedures (i.e. tubal ligation). |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Electrical Epidural Stimulation Test (EST) | Diagnostic Test | EST measures sensory/motor responses |
|
| Measure | Description | Time Frame |
|---|---|---|
| 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) |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Ban C.H. Tsui, MD | Contact | (650) 200-9107 | bantsui@stanford.edu | |
| Ksenia Kasimova, MD | Contact | (650) 788-9458 | kasimova@stanford.edu |
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| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 25501494 | Result | 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;62(3):265-70. doi: 10.1007/s12630-014-0291-x. Epub 2014 Dec 11. | |
| 30613393 | Result |
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| ID | Term |
|---|---|
| D048949 | Labor Pain |
| ID | Term |
|---|---|
| D010146 | Pain |
| D009461 | Neurologic Manifestations |
| D012816 | Signs and Symptoms |
| D013568 | Pathological Conditions, Signs and Symptoms |
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Patients with deactivated epidural/CSE catheters will be given electrical epidural stimulation test to detect its ability to be reactivated.
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| 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. |
| 9717595 | Result | 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. |