Ultrasound of spine in pregnancy study
Research type
Research Study
Full title
Influence of body position on the identification of Tufters line in parturients. A Double blinded prospective study. Does the lateral position lead to decreased accuracy?
IRAS ID
178733
Contact name
Nhathien Nguyen-Lu
Contact email
Sponsor organisation
Guy's & St Thomas’s Foundation NHS Trust
Duration of Study in the UK
0 years, 3 months, 0 days
Research summary
Anaesthesia for caesarean delivery can be provided via regional anaesthesia (spinal or epidural anaesthesia). Patient will be positioned in a sitting or lying on the side position. Traditionally, an anaesthetic doctor will feel the lower back and hips to identify a suitable location to inject the local anaesthetic to provide anaesthesia for surgery. We now have the technology to use ultrasound to visualize the patient’s spine to accurately locate a suitable point of injection. Previous studies have shown that the use of ultrasound of spines may be a useful tool and can reduce the risk of having a failed or traumatic spinal/epidurals.
This study aims to compare the accuracy of the palpation technique using external landmarks of patient’s back in both sitting and lying position using ultrasound guided identification of a suitable point of injection.
Landmark technique involves palpating the hipbone to join an imaginary line. Where is line intersects the spine is the L4/5 space. The anaesthetist will choose to insert the spinal or epidural anaesthesia at this level or one level higher. A space is felt between the prominences of the spinal bones.
Ultrasound of the spine involves planning an ultrasound probe over to spine to visualise the spine to find the exact level to insert spinal or epidual.
During participants antenatal visit we will need approximately only 30 minutes of their time. One senior anaesthetic doctor will feel participants back in the sitting and lying on side positions. Another anaesthetic doctor will use ultrasound to identify the intended point of injection. They will mark their intended insertion points using invisible ink (safe on skin) which will be revealed using UV light pen, these marks will be removed afterwards with soap and water. Small measurements of distance between the points will be collected using a ruler on your back.
With the results, we hope to be able to propose a protocol to better advise anaesthetists on how to identify the ideal injection point, which can lead to increased safety and comfort for pregnant patients receiving regional anaesthesia in the future.
REC name
South Central - Oxford C Research Ethics Committee
REC reference
15/SC/0712
Date of REC Opinion
12 Nov 2015
REC opinion
Favourable Opinion