Sonographic Predictors of Difficult Epidural Placement.

Study Overview
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Brief Summary
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Epidural placement is a commonly used procedure for pain management during labor, delivery, and surgeries. However, epidural placement is often considered a technically challenging and complex procedure that requires a high level of skill and experience. In cases where the epidural is improperly placed or fails to produce effective analgesia, the discomfort and distress experienced by the patient may be heightened. Hence, the use of predictors, such as sonographic ones, may prove to be a valuable tool for healthcare professionals in the placement of epidurals, ultimately ensuring successful pain management for patients. The present study aims to identify predictors of difficult epidural placement in patients undergoing surgery.

Official Title
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Sonographic Predictors of Difficult Epidural Placement.

Conditions
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Anesthesia, Safety Issues, Epidural; Anesthesia, Headache

Intervention / Treatment
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* Other: Data collection


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Surgery with epidural placement Age > 18 years Exclusion Criteria: patient refusal

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Epidural placement<br>All patients undergoing epidural placement will be enrolled. | Other: Data collection<br>* Several data will be collected such as: Age, weight, height, gender, previous spine surgery, skoliosis (Y/N), palpable spinous process (Y/N), experience in years of anesthesiologist, spine level of epidural placement and the following sonographic parameters at the level of epidural placement: skin-spinous process distance (cm), skin-transversous process distance (cm), erector spinae plane distance (cm), superior to inferior spinous process distance (cm)<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Incidence of difficult epidural placement | Described as the requirement to replace the needle by fully removing it from the skin. | through study completion, an average of 2 year | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Total body weight (kg) as predictive parameter for difficult epidural placement | Total body weight (kg) as predictive parameter for difficult epidural placement | through study completion, an average of 2 year | 
| Age (years) as predictive parameter for difficult epidural placement | Age (years) as predictive parameter for difficult epidural placement | through study completion, an average of 2 year | 
| Height (cm) as predictive parameter for difficult epidural placement | Height (cm) as predictive parameter for difficult epidural placement | through study completion, an average of 2 year | 
| Palpable spinous process (well, not well, not palpable) as predictive parameter for difficult epidural placement | Palpable spinous process (well, not well, not palpable) as predictive parameter for difficult epidural placement | through study completion, an average of 2 year | 
| Previous spine surgery (yes, no) as predictive parameter for difficult epidural placement | Previous spine surgery (yes, no) as predictive parameter for difficult epidural placement | through study completion, an average of 2 year | 
| Anesthesiology experience (years) as predictive parameter for difficult epidural placement | Anesthesiology experience (years) as predictive parameter for difficult epidural placement | through study completion, an average of 2 year | 
| Sonographic skin to spinous process distance(cm) as predictive parameter for difficult epidural placement | Sonographic skin to spinous process distance (cm) as predictive parameter for difficult epidural placement | through study completion, an average of 2 year | 
| Sonographic spinous process to spinous process distance (cm)as predictive parameter for difficult epidural placement | Sonographic spinous process to spinous process distance (cm)as predictive parameter for difficult epidural placement | through study completion, an average of 2 year | 
| Sonographic skin to transverse process distance (cm) as predictive parameter for difficult epidural placement | Sonographic skin to transverse process distance (cm) as predictive parameter for difficult epidural placement | through study completion, an average of 2 year | 
| Sonographic erector spine muscle group size (cm) as predictive parameter for difficult epidural placement | Sonographic erector spine muscle group size (cm) as predictive parameter for difficult epidural placement | through study completion, an average of 2 year | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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technique, epidural, predictors, placement