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Led by Stanford University · Updated on 2025-05-01
40
Participants Needed
1
Research Sites
N/A
Total Duration
Researchers are evaluating the use of the Electrical Epidural Stimulation Test EST to confirm the placement of epidural catheters in laboring women. This study focuses on women with full-term pregnancies requesting epidural analgesia during labor or cesarean section. The EST, first described by the principal investigator about 20 years ago, measures sensory and motor responses to ensure proper catheter placement, addressing the challenge of confirming epidural catheter positioning during single-segment needle-through-needle combined spinal-epidural analgesia. During the study, laboring women receive the EST before administering local anesthetic and again one hour after anesthetic introduction through the catheter. The test aims to detect sensory and motor responses linked to correct catheter placement. The epidural catheter is used to extend and provide continuous pain relief during labor. The study evaluates the duration of the EST and monitors pain scores approximately three hours after anesthetic administration. Participants will undergo assessments including the EST at specified time points to measure its effectiveness in confirming catheter placement. Researchers will record the duration of the EST, which lasts about 1 to 2 hours, and collect pain scores following anesthetic use. The study does not use blinding and focuses on safety and accuracy of the diagnostic test. Participation includes monitoring sensory and motor responses and pain levels during labor to help improve epidural analgesia techniques.
CONDITIONS
Obstetric Placement Study Using EST
C
Chynna Villanueva, BS, RN
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Stanford University
Lead Sponsor
This table compares participation in this trial with other options available for this condition. The information is drawn from published research and the trial’s study details and is provided for educational purposes only.
| Factors | EST (investigational) | Standard confirmation |
|---|---|---|
| What it is | A diagnostic test that uses electrical stimulation through the epidural catheter to confirm correct placement by observing sensory or motor responses. | Standard methods to confirm epidural catheter placement include clinical response to a test dose, loss‑of‑resistance technique supported by pressure waveform analysis, or observing onset of numbness or pain relief. |
| Role in trial | Administered sequentially as the study diagnostic method for evaluating catheter placement in laboring women. | Represents clinical context but was not tested in this trial arm. |
| Primary use | To confirm correct epidural catheter placement before administering anesthetic during labor. | Common clinical practice methods used to ensure the catheter is properly placed before dosing. |
| How it is performed | A small electrical current is passed through the epidural catheter to elicit a motor or sensory response indicating correct epidural placement. | Performed using loss of resistance during needle insertion, test‐dose injection, or monitoring pressure waveforms; confirmation by clinical signs emerges after dosing. |
| Important risks | Not specifically reported; potential electrical stimulation may pose minor discomfort but risks are not detailed in the registry. | Injection of test dose may cause anesthetic spread; loss‐of‐resistance has minimal direct risk; pressure waveform methods are non‑invasive. |
| Important limitations | Single‑group design lacks direct comparison; diagnostic accuracy (sensitivity, specificity) remains to be established. | Clinical confirmation methods can take time or be unreliable; may lack immediate objective feedback. |
Disclaimer: This comparison is created with the help of artificial intelligence(AI) and may contain errors or missing information. It is not medical advice and does not mean one option is better or safer than another. Clinical trials are still being studied, and joining a trial is your choice. Please consult your healthcare professional before making any decisions.
You may qualify if you...
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Duration - 2 to 4 weeks
Participants are screened for eligibility to participate in the trial.
1 visit (in-person)
Duration - Approximately 1 to 2 hours
Participants undergo the Electrical Epidural Stimulation Test (EST) before and after local anesthetic administration to measure sensory and motor responses during labor.
1 visit (in-person)
Duration - Approximately 3 hours
Participants have pain scores assessed approximately 3 hours following anesthetic introduction through the catheter.
1 visit (in-person)
Study Type
INTERVENTIONAL
Masking
NONE
Allocation
NA
Model
SEQUENTIAL
Primary Purpose
DIAGNOSTIC
Number of Arms
1
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Jose C A Carvalho, Rakhi Khemka, Julian Loke...
https://pubmed.ncbi.nlm.nih.gov/25501494/Stanford University
Lead Sponsor
