Comparison of Loss of Resistance Techniques

Study Overview
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Brief Summary
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The purpose of this study is to determine whether there is a difference in success outcome of the combined spinal epidural labor analgesia between air versus saline when used to identify the epidural space.

Detailed Description
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When the epidural needle is inserted initially, it is typically connected to a syringe filled with 2-3 ml or air or saline. This is used to help identify the placement of the epidural needle. Both air and saline are commonly used and it is not clear and debatable which is a better method to identify the correct placement of the needle. Some doctors like using air in the syringe because when a drop of clear fluid returned from the smaller spinal needle, it would be clear to indicate the correct space for first dose of medicine since no pre-existing fluid was used. In group Saline, 3 mL of saline will be used. In group Air, 3 mL of air will be used in the syringe during the procedure. The medicine will be administered in the usual manner the doctor has identified the correct location for administration. The amount of pain during labor will be assessed the patient giving a number from 0 to 10 with 0 being no pain and 10 being the worst pain.

Official Title
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Comparison of Loss of Resistance Technique With Air Versus Saline to Identify Epidural Space for Combined Spinal Epidural Labor Analgesia

Conditions
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Pain Relief

Intervention / Treatment
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* Procedure: Air
* Procedure: Saline


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Pregnant females weighing less than or equal to 250 lbs Request for neuraxial labor analgesia Exclusion Criteria: ASA physical status greater than II
Sexes Eligible for Study
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Female

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: Other
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Single


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Active Comparator: Air<br>Air 3 ml used to identify epidural space | Procedure: Air<br>* 3 mls used for identifying epidural space<br>|
| Active Comparator: Saline<br>Saline 3 ml used to identify epidural space | Procedure: Saline<br>* 3 mls of saline used to identify epidural space<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Success of Spinal Labor Analgesia From Combined Spinal Epidural | Number of participants that had successful spinal labor analgesia in each group. | 24 hours | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Number of Participants With Failed Epidural Catheters | Number of Participants with Failed Epidural Catheters and that had to be replaced at any time measured from the time of the catheter is placed until the time of delivery. | 24 hours | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Quality of pain relief with 2 different methods of identifying epidural space