Unique ID issued by UMIN | UMIN000027843 |
---|---|
Receipt number | R000029178 |
Scientific Title | Observational study for improvement of identifying the intervertebral space for indwelling an epidural catheter |
Date of disclosure of the study information | 2017/08/01 |
Last modified on | 2017/12/06 22:05:52 |
Observational study for improvement of identifying the intervertebral space for indwelling an epidural catheter
Study for better identification of intended intervertebral space in epidural anesthesia
Observational study for improvement of identifying the intervertebral space for indwelling an epidural catheter
Study for better identification of intended intervertebral space in epidural anesthesia
Japan |
Patients who received epidural anesthesia during surgery
Anesthesiology |
Others
NO
The accuracy of identifying the intervertebral space during lower thoracic epidural anesthesia is unreliable. In our previous study, we determined a linear regression model with the body height as the independent variable, the length of the thoracic spine (to be exact, the distance between the seventh cervical spinous process and the twelfth thoracic spinous process) as the dependent variable. In this study, we will prototype a universal ruler that converts the body height to the thoracic length based on the primary equation. Next, when the intervertebral space is specified using the ruler, it is examined whether the specific accuracy improves over the conventional identification method.
Efficacy
Confirmatory
Pragmatic
Not applicable
Using the prediction formula to calculate the length of the thoracic spine from body height, we determine the estimated position of the 12th thoracic spinous process of the participants. The epidural catheter is then indwelled from any intervertebral space with reference to that position. In the postoperative X - ray, the actual indwelling intervertebral space and the predicted intervertebral space are obtained. When the difference is 0, we determined as success, otherwise when deviation within the 1 vertebra,
we determined as intermediate success. Between the cases of epidural puncture using prediction formula and puncture using other methods, that is, puncture using conventional method, we find success ratio and intermediate success ratio. The main evaluation item is the success ratio and the intermediate success ratio. It is judged whether there is a statistically significant difference in the success ratio between the two groups.
We will process the influence of the background factor of the patient and that of participating doctors on the predictive value by multivariate analysis. We use this result as a secondary evaluation item.
Observational
18 | years-old | <= |
99 | years-old | >= |
Male and Female
Patients who underwent surgery on the upper or lower abdomen performed by gastroenterologic surgery, obstetrics and gynecology, and urology under general anesthesia with epidural anesthesia
1 Patients with marked deformity and degeneration of the spine
2 Patients who are difficult to identify punctured intervertebra space due to poor visualization of epidural catheter and spine with postoperative radiograph
60
1st name | |
Middle name | |
Last name | Shinji Nozuchi |
Saiseikai Shiga Hospital
dept. of anesthesia
2-4-1, Ohashi, Ritto city, Shiga, japan
077-552-1221
dob3gamma-mag01@yahoo.co.jp
1st name | |
Middle name | |
Last name | Tadashi Shigematsu |
Saiseikai Shiga Hospital
dept. of ethical comittie
2-4-1, Ohashi, Ritto city, Shiga, japan
077-552-1221
dob3gamma-mag01@yahoo.co.jp
Department of anesthesia, Saiseikai Shiga hospital,Shiga, JAPAN
Department of anesthesia, Saiseikai Shiga hospital,Shiga, JAPAN
Self funding
NO
済生会滋賀県病院(滋賀県)
2017 | Year | 08 | Month | 01 | Day |
Unpublished
The estimated intervertebral level and the confirmed intervertebral level confirmed perfectly between the 2 groups of the conventional method (group C) and predictive formula usage group (group S) were 32.2% for group C and 32.2% and 54.1% for group S(p = 0.00176). On the other hand, the concordance rate allowed up to +-1 vertebral discrepancy was 98.4% (p = 0.000195) in S group versus 76.3% in C group.
Completed
2017 | Year | 07 | Month | 31 | Day |
2017 | Year | 08 | Month | 01 | Day |
2017 | Year | 10 | Month | 31 | Day |
2017 | Year | 11 | Month | 01 | Day |
2017 | Year | 11 | Month | 01 | Day |
2017 | Year | 11 | Month | 10 | Day |
We obtain presumed thoracic length of the scheduled surgery patient by using the prediction formula that estimates the total length of the thoracic vertebra from the body height obtained by our previous study. Participating anesthetists select the arbitrary thoracic intervertebral level as the puncture site of epidural anesthesia with reference to that distance and describe it as the predicted intervertebral space. Postoperatively we obtain an actual puncture intervertebral space with an X - ray photograph. We calculate the degree of coincidence between the predicted intervertebral space and actual vertebral space and demonstrate that the accuracy of puncture vertebrae improvement by this method is better than before.
2017 | Year | 06 | Month | 20 | Day |
2017 | Year | 12 | Month | 06 | Day |
Value
https://center6.umin.ac.jp/cgi-open-bin/ctr_e/ctr_view.cgi?recptno=R000029178