Effect of Crossed Legged Position on Ultrasound Measured Posterior Longitudinal Ligament Length in Parturients.
Study Details
Study Description
Brief Summary
To investigate if sitting in flexed cross legged position for neuraxial techniques in term pregnant patients widens the size of the ultrasound acoustic window as measured by the visualized posterior longitudinal ligament length, during lumbar spine ultrasonography using longitudinal paramedian view, in comparison to the standard sitting flexed position.
| Condition or Disease | Intervention/Treatment | Phase |
|---|---|---|
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Detailed Description
This is a prospective observational study involving a total of 30 healthy term gestation pregnant patients with singleton fetuses.Patients will be randomly allocated to sit crossed leg or in standard position first. Using ultrasonography, the acoustic window for lumbar spinal anesthesia at L3-4 will be evaluated in both traditional sitting and crossed leg positions. Ultrasonography will be performed sequentially to measure the best visualized length of posterior longitudinal ligament,ligamentum flavum and interlaminar distance in the paramedian view.The scanned image will be saved to be remeasured by a third observer. Patients will be asked to score their comfort level while sitting in both positions.
Study Design
Arms and Interventions
| Arm | Intervention/Treatment |
|---|---|
| Crossed leg position Patients in this group will be randomly allocated to sit in crossed leg position first.Ultrasonography will be performed in this position to measure the best visualized length of posterior longitudinal ligament, ligamentum flavum and interlaminar distance at L3-4 lumbar level as by Operator 1 . These measurements will be recorded by Operator 2 using intrinsic caliper software.Operator 1 will not be told the measurements. |
Device: Ultrasonography
Length of Posterior Longitudianl Ligament, Ligamentum Flavum and Interlaminar distance visible in paramedian longitudinal view during lumbar spine ultrasonography in cross legged position will be compared to standard sitting position.
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| Standard Sitting position Patients in this group will be randomly allocated to sit in standard position first.Ultrasonography will be performed in this position to measure the best visualized length of posterior longitudinal ligament, ligamentum flavum and interlaminar distance at L3-4 lumbar level as by Operator 1 . These measurements will be recorded by Operator 2 using intrinsic caliper software.Operator 1 will not be told the measurements. |
Device: Ultrasonography
Length of Posterior Longitudianl Ligament, Ligamentum Flavum and Interlaminar distance visible in paramedian longitudinal view during lumbar spine ultrasonography in cross legged position will be compared to standard sitting position.
|
Outcome Measures
Primary Outcome Measures
- PLL length [Up to Five minutes]
Length of the Paravertebral Longitudinal Ligament, as measured by the intrinsic ultrasound caliber tool in mm.
Secondary Outcome Measures
- LF length [Up to Five minutes]
Length of the Ligamentum Flavum as measured by the intrinsic ultrasound caliber tool in mm.
- ILD length [Up to Five minutes]
Length of the interlaminar distance, as measured by the intrinsic ultrasound caliber tool in mm.
- Patient Comfort [Up to 5 minutes]
Patient comfort level measured on a 1-5 Likert Scale
Eligibility Criteria
Criteria
Inclusion Criteria:
Term gestation Singleton pregnancy 18 years or older Patients having elective cesarean delivery or induction of labor or in early labor
Exclusion Criteria:
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Allergy to ultrasound jelly
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Spinal Deformities/Previous spinal surgery
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No contraindication to neuraxial placement
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Any fetal concerns
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Morbid obesity
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Language barrier
Contacts and Locations
Locations
No locations specified.Sponsors and Collaborators
- Lawson Health Research Institute
Investigators
- Principal Investigator: Indu Singh, FRCPC, Western University
Study Documents (Full-Text)
None provided.More Information
Publications
None provided.- 107570