Quantification of the pressures generated during insertion of an epidural needle in labouring women of varying body mass indices.

Wee, M.Y.K., Isaacs, R.A., Vaughan, N., Dubey, V. N. and 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, 24 - 31.

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Abstract

Objective: 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, stratifi ed 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.

Item Type:Article
ISSN:2332-2780
Uncontrolled Keywords:Epidural; Pressures; Simulation; Obstetrics
Group:Faculty of Science & Technology
ID Code:30486
Deposited By: Unnamed user with email symplectic@symplectic
Deposited On:19 Mar 2018 11:48
Last Modified:19 Mar 2018 11:48

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