Quantification of the pressures generated during insertion of an epidural needle in labouring women of varying body mass indices
AffiliationUniversity of Chester; Bournemouth University; Poole Hospital NHS Trust; West Hertfordshire NHS Trust; Southampton University Hospital
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AbstractObjective: The primary aim of this study was to measure pressure generated on a Tuohy needle during the epidural procedure in labouring women of varying body mass indices (BMI) with a view of utilising the data for the future development of a high fi delity epidural simulator. High-fi delity epidural simulators have a role in improving training and safety but current simulators lack a realistic experience and can be improved. Methods: This study was approved by the National Research Ethics Service Committee South Central, Portsmouth (REC reference 11/SC/0196). After informed consent epidural needle insertion pressure was measured using a Portex 16-gauge Tuohy needle, loss-of-resistance syringe, a three-way tap, pressure transducer and a custom-designed wireless transmitter. This was performed in four groups of labouring women, stratified according to BMI kg/m2: 18-24.9; 25-34.9; 35-44.9 and >=45. One-way ANOVA was used to compare difference in needle insertion pressure between the BMI groups. A paired t-test was performed between BMI group 18-24.9 and the three other BMI groups. Ultrasound images of the lumbar spine were undertaken prior to the epidural procedure and lumbar magnetic resonance imaging (MRI) was performed within 72h post-delivery. These images will be used in the development of a high fi delity epidural simulator. Results: The mean epidural needle insertion pressure of labouring women with BMI 18-24.9 was 461mmHg; BMI 25-34.9 was 430mmHg; BMI 35-44.9 was 415mmHg and BMI >=45 was 376mmHg, (p=0.52). Conclusion: Although statistically insignifi cant, the study did show a decreasing trend of epidural insertion pressure with increasing body mass indices.
CitationWee, M. Y. K., Isaacs, R. A., Vaughan, N., Dubey, V. N., & Parker, B. (2017). Quantification of the pressures generated during insertion of an epidural needle in labouring women of varying body mass indices. International Journal of Clinical Anesthesia and Research, 1, 024-031. http://doi.org/10.29328/journal.hacr.1001004
PublisherHeighten Science Publications
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