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Trial registered on ANZCTR
Registration number
ACTRN12618000578202
Ethics application status
Approved
Date submitted
6/03/2018
Date registered
16/04/2018
Date last updated
2/10/2018
Type of registration
Prospectively registered
Titles & IDs
Public title
Correlation of actual epidural depth with ultrasonographic measurements at transverse plane and sagittal paramedian oblique plane in parturients undergoing elective cesarean section with combined spinal epidural anesthesia
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Scientific title
Correlation of actual epidural depth with ultrasonographic measurements at transverse plane and sagittal paramedian oblique plane in parturients undergoing elective cesarean section with combined spinal epidural anesthesia
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Secondary ID [1]
294241
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none
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Universal Trial Number (UTN)
U1111-1210-3274
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Trial acronym
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
combined spinal epidural anesthesia
306918
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cesarean section
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Condition category
Condition code
Anaesthesiology
306013
306013
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0
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Other anaesthesiology
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Surgery
306014
306014
0
0
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Other surgery
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Musculoskeletal
306015
306015
0
0
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Normal musculoskeletal and cartilage development and function
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Reproductive Health and Childbirth
306016
306016
0
0
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Childbirth and postnatal care
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Intervention/exposure
Study type
Observational
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Patient registry
False
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Target follow-up duration
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Target follow-up type
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Description of intervention(s) / exposure
The measurements will be done at the operation room after monitorization of the parturient in accordance with the standards of American Society of Anesthesiologists. Patient will be placed at sitting position on the operation table and ultrasonography will be done at this position which will also be the position for combined spinal epidural anesthesia. An anesthesiologist experienced in sonoanatomy will do the ultrasonographic examination of epidural space in both transverse and sagittal paramedian oblique plane. The depth of epidural space in both examinations will be recorded. While performing combined spinal epidural anesthesia, after aseptic preparing the skin and infiltration of entry site for epidural needle with local anesthetic drug, epidural needle will be introduced from skin through epidural space with loss of resistance technique. At the point epidural space is reached, epidural needle will be marked with a sterile permenant marker and after introducing spinal needle through epidural needle, free flow of cerebrospinal fluid will be observed, spinal needle will be locked within the epidural needle and 2ml 0.5% hyperbaric bupivacaine will be injected. The distance between the tip of epidural needle and the spinal needle will be measured. The actual depth of epidural space will be measured as the distance marked on the epidural needle to its tip. The depth of subarachnoid space will be accepted as the distance between the tip of spinal needle and the tip of epidural needle plus the measured actual epidural depth which was formerly defined.
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Intervention code [1]
300535
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Not applicable
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Comparator / control treatment
no control group
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Control group
Uncontrolled
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Outcomes
Primary outcome [1]
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One of the composite outcomes of the study is determination of epidural depth at transverse plane and sagittal paramedian oblique plane with ultrasound in parturients undergoing elective cesarean section with combined spinal epidural anesthesia.
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Assessment method [1]
305048
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Timepoint [1]
305048
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following the acceptance of parturient into the operation room, just before the cesarean section.
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Primary outcome [2]
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determination of actual epidural depth with measuring the epidural and spinal needle lengths introduced from the skin to the epidural and subarachnoid spaces.
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Assessment method [2]
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Timepoint [2]
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after administration of combined spinal epidural anesthesia just before cesarean section.
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Primary outcome [3]
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Another composite outcome of the study is determining the correlation between actual epidural depth and epidural depth measured with ultrasound at transverse plane and sagittal paramedian oblique plane. Actual epidural depth is measured as follows: Epidural needle is inserted with loss of resistance to air technique and when epidural space is located a permenant marker is used to mark the length of epidural needle at the level of patient's skin. The distance between the marked point on the epidural neddle to the tip of epidural needle is accepted as actual epidural depth.
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Assessment method [3]
305050
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Timepoint [3]
305050
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following the acceptance of parturient to operation room, just before the start of cesarean section.
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Secondary outcome [1]
345339
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A composite secondary outcome is determining the correlation between parturients' BMI and the epidural depth measurements with ultrasound at transverse and sagittal paramedian oblique planes.
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Assessment method [1]
345339
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Timepoint [1]
345339
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following the acceptance of parturient into the operation room, just before the cesarean section.
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Eligibility
Key inclusion criteria
parturients undergoing elective cesarean section with combined spinal epidural anesthesia
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Minimum age
18
Years
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Maximum age
40
Years
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Sex
Females
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Can healthy volunteers participate?
No
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Key exclusion criteria
multiple and/or complicated pregnancies, eclampsia, preeclampsia, American society of anesthesiologists physical risk score >II, Any contraindication for combined spinal epidural anesthesia, coagulopathy and/or anticoagulant drug use , patient refusal to participate to study, and emergency cases.
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Study design
Purpose
Screening
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Duration
Cross-sectional
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Selection
Defined population
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Timing
Prospective
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Statistical methods / analysis
IBM SPSS ver 21.0 will be used to analyze the data collected. mean, standard deviation, frequencies, median will be used for the analysis of quantitative data. normal distribution of data will be analyzed by Kolmogorov- Smirnow and Shapiro Wilk tests. Spearman's rho correlation and Pearson correlation tests will be used to analyze the correlation between the actual epidural depth and the epidural depth measured with ultrasound at saggital paramedian oblique plane and transverse plane. Bland altman plot will also be used to compare the epidural depth measurements.
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Recruitment
Recruitment status
Completed
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Date of first participant enrolment
Anticipated
1/06/2018
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Actual
2/06/2018
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Date of last participant enrolment
Anticipated
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Actual
28/09/2018
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Date of last data collection
Anticipated
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Actual
28/09/2018
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Sample size
Target
80
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Accrual to date
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Final
80
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Recruitment outside Australia
Country [1]
9649
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Turkey
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State/province [1]
9649
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kirsehir
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Funding & Sponsors
Funding source category [1]
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Hospital
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Name [1]
298880
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hi evran university training and research hospital
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Address [1]
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medical doctor at ahi evran university training and research hospital address: kervansaray mahallesi 2019.sokak no:1 merkez/kirsehir/turkey p.k.40100
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Country [1]
298880
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Turkey
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Primary sponsor type
Individual
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Name
mehmet cantürk
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Address
ahi evran university training and research hospital
address: kervansaray mahallesi 2019.sokak no:1
merkez/kirsehir/turkey
p.k.40100
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Country
Turkey
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Secondary sponsor category [1]
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None
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Name [1]
298093
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none
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Address [1]
298093
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none
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Country [1]
298093
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
299822
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ahi evran üniversitesi tip fakültesi klinik arastirmalar etik kurulu
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Ethics committee address [1]
299822
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ahi evran üniversitesi tip fakültesi bagbasi yerleskesi Kat: 0 40100 merkez, Kirsehir, Turkey
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Ethics committee country [1]
299822
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Turkey
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Date submitted for ethics approval [1]
299822
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15/12/2017
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Approval date [1]
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26/12/2017
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Ethics approval number [1]
299822
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2017-20/242
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Summary
Brief summary
combined spinal epidural anesthesia is frequently used for cesarean section in our institution. Conventional palpation method has widely been used to locate the intervertebral space resulting in some complications. with the developments in technology and widespread use of ultrasound, precise navigation of intervertebral space is easier with almost exact results. ultrasound guides the anesthesiologist to navigate the desired intervertebral space to introduce the epidural needle, gives provision of the precise insertion angle for the needle and predicts the depth of epidural space where epidural needle can be introduced safely. this results in reduced complications and increased patient safety. There is a almost no data in the literature comparing the correlation of ultrasonographic measurements of epidural depth at saggital paramedian oblique plane and transverse plane with the actual epidural depth. The aim of the current study is to measure the epidural depth with ultrasound at saggital paramedian oblique plane and transverse plane in parturients scheduled for elective cesarean section with combined spinal epidural anesthesia and determine the correlations of these measurements with the actual epidural depth.
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Trial website
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Trial related presentations / publications
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Public notes
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Contacts
Principal investigator
Name
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Dr mehmet cantürk
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Address
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ahi evran university training and research hospital address: kervansaray mahallesi 2019.sokak no:1 merkez/kirsehir/turkey p.k.40100
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Country
81674
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Turkey
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Phone
81674
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+905053574372
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Fax
81674
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Email
81674
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[email protected]
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Contact person for public queries
Name
81675
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mehmet cantürk
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Address
81675
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ahi evran university training and research hospital address: kervansaray mahallesi 2019.sokak no:1 merkez/kirsehir/turkey p.k.40100
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Country
81675
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Turkey
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Phone
81675
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+905053574372
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Fax
81675
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Email
81675
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[email protected]
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Contact person for scientific queries
Name
81676
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mehmet cantürk
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Address
81676
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ahi evran university training and research hospital address: kervansaray mahallesi 2019.sokak no:1 merkez/kirsehir/turkey p.k.40100
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Country
81676
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Turkey
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Phone
81676
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+905053574372
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Fax
81676
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Email
81676
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[email protected]
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No information has been provided regarding IPD availability
What supporting documents are/will be available?
No Supporting Document Provided
Results publications and other study-related documents
Documents added manually
No documents have been uploaded by study researchers.
Documents added automatically
No additional documents have been identified.
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