Evaluation of Ultrasound (US) Assistance for Anesthesia Trainees for Caesarean Section Spinal Placement

Study Overview
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Brief Summary
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Parturients receiving spinal anesthetic for Cesarean section will be randomized to have/not have pre-spinal ultrasound examination of their back.

Detailed Description
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Parturients receiving spinal anesthetic for elective Cesarean section will be randomized to have/not have pre-spinal ultrasound examination of their back, prior to spinal insertion by anesthesia trainees. The hypothesis is that ultrasound visualization of the patient spinal spaces will allow junior residents to correctly place the spinal needle with fewer attempts. The null hypothesis is that there is no difference in the primary outcome (number of attempts). i.e. the investigators hypothesize that the number of attempts is not affected by ultrasound assistance. The control group will undergo spinal anesthesia with manual palpation, the standard of care.

Official Title
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Evaluation of US Assistance for Anesthesia Trainees for Spinal Placement in Parturients Having Caesarean Section: A Randomized Control Trial

Conditions
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Pregnancy

Intervention / Treatment
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* Device: Ultrasound examination


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Parturient scheduled for elective spinal anesthetic for caesarean section. Resident level PGY1 or PGY2. Resident experience between 2-25 spinal anesthetics. ASA 1-3 scheduled for elective sections Exclusion Criteria: Parturient BMI > 40. Emergency C-section. Previous spinal surgery or scoliosis. Parturient refusal Resident refusal Multiple gestations

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 45 Years

Sexes Eligible for Study
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Female

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Design Details

Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Single


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Ultrasound<br>Trainees will receive pre-procedure U/S guided examination of the parturient's back. | Device: Ultrasound examination<br>* Trainees will receive pre-procedure U/S guided examination of the parturient's back.<br>* Other names: M-turbo;|
| No Intervention: Control<br>Control group. (Standard practice) Trainees will NOT receive pre-procedure U/S guided examination. | |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Number of attempts at intrathecal needle tip placement during spinal anesthesia. |  | Day 1 | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| 1. Time to place spinal anesthetic (seconds), measured from introducer placement to confirmation of cerebral spinal fluid (CSF). |  | Day 1 | 
| Space used for 1st attempt, as estimated by palpation or U/S |  | Day 1 | 
| Number of spaces used |  | Day 1 | 
| Dural depth (cm) |  | Day 1 | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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pregnancy, Caesarian, section, spinal