Continuous Labor Epidural Catheter for Tubal Ligation Study

Study Overview
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Brief Summary
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This study is to study the success rate of using the epidural catheter that was placed during the labor for the surgical anesthesia to perform a postpartum tubal ligation.

Official Title
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Success Rate, Efficiency, and Predictors of Reactivation of a Continuous Labor Epidural Catheter for Postpartum Tubal Ligation

Conditions
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Tubal Ligation, Bilateral Tubal Ligation

Intervention / Treatment
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* Other: Epidural anesthetic
* Other: Spinal anesthetic


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: American Society of Anesthesiologists (ASA) 1-3 postpartum women desiring Postpartum Bilateral Tubal Ligation (PPBTL) for infertility Functional epidural catheter placed for labor and delivery analgesia The epidural is still taped within 1cm of the original depth when it was functional for labor analgesia 1-45 years of age Exclusion Criteria: ASA 4 status History of dural puncture (wet tap) during initial epidural catheter insertion History of marginal or inadequate epidural analgesia for labor Cesarean section for delivery Examination demonstrates that the indwelling catheter has migrated more than 1 cm from the original depth when secured The end of indwelling epidural catheter appears to have not been capped appropriately or the cap was not maintained intact Prolonged sensory or motor block, bladder or anal sphincter dysfunction, nerve damage, inability to ambulate, post-dural puncture headache (PDHD), or seizures, during or after delivery and following cessation of the epidural catheter dosing Pseudocholinesterase deficiency Allergy to Nesacaine® (chloroprocaine) or lidocaine General anesthesia provided for delivery History of substance abuse disorder History of major psychiatric disorder Non-English reading/speaking participants

Ages Eligible for Study
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Minimum Age: 19 Years
Maximum Age: 45 Years

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: Supportive Care
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Double


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Other: Spinal Anesthetic Group<br>This group will receive spinal anesthetic for the surgical procedure and will serve as the control group for this study. | Other: Spinal anesthetic<br>* This group was assigned to receive spinal anesthetic for postpartum tubal ligation.<br>|
| Experimental: Epidural Anesthetic Group<br>This is the experimental group for this study. | Other: Epidural anesthetic<br>* Use of the existing continuous labor epidural for surgical anesthetic for postpartum tubal ligation<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Success Rate of Reactivation of Existing Continuous Labor Epidural Catheter for Postpartum Tubal Ligation | Rate of reactivation of the epidural catheter for postpartum tubal ligation in the group that was randomized to the epidural anesthetic group. (Need for additional supplemental analgesics and sedatives or the need to convert to general anesthesia.) | at the time of surgery | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Impact of Anesthesia Type on OR (Operating Room) Efficiency | The time minutes)from initiation of anesthesia to surgery start. | minutes until surgery start |