Real-time Ultrasound-guided Paramedian Epidural Access: Evaluation of a Novel In-plane Transverse View Technique

Study Overview
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Brief Summary
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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 performance time. Block success rate. Needle Depth to epidural space 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

Conditions
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Epidural Placement

Intervention / Treatment
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* Other: epidural needle placement with echogenic 17G Tuohy needles (Pajunk TuohySono)
* Other: standard epidural placement


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Adult Patients 30 to 80 years old at time of surgery. Patients in whom epidural anesthesia is planned to be used as the for surgery  Surgical epidural Exclusion Criteria: Current or recent drug abuse (within past 6 months). Allergy to local anesthetics Patient refusal.

Ages Eligible for Study
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Minimum Age: 30 Years
Maximum Age: 80 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Basic Science
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: echogenic 17G tuohy needles  Pajunk TuohySono<br>Epidural will be placed with the aid of ultrasound and echogenic 17G Tuohy needles (Pajunk TuohySono). | Other: epidural needle placement with echogenic 17G Tuohy needles (Pajunk TuohySono)<br>* Anesthesiologist will place epidural with aid of ultrasound and placement with echogenic 17G Tuohy needles (Pajunk TuohySono)<br>|
| Placebo Comparator: standard epidural needles<br>Epidural will be placed in standard practice with standard needles. | Other: standard epidural placement<br>* Anesthesiologist will place epidural within standard practice, with standard needles.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | 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 | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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epidural