Introduction Real-time ultrasound-guided thoracic epidural catheter placement (US-TECP) has been recently introduced. Patient’s position is associated with the success of spine interventions; however, the effects of position on the outcome of the procedure remain unknown. We aimed to assess the clinical usefulness of patient positioning during real-time US-TECP.
Methods Patients were randomly assigned to the prone position group (group P) and sitting position group (group S). The primary outcome was needling time during the procedure. The secondary outcomes were time to mark space, total number of needle passes, number of skin punctures, first-pass success, final success, crossover success, and visibility of ultrasound (US) views. Global Rating Scale (GRS) score, Patient Comfort Scale score, procedural pain intensity, patient satisfaction, and procedure-related complications were also determined.
Results Sixty-four patients were included in this study. The needling time was significantly shorter in group P than in group S (36.5 (26.5–51.0) vs 59.5 (34.5–152.0) s, p<0.01). The numbers of needle passes and skin punctures were significantly lesser in group P than in group S. First-pass success was higher in group P than in group S. Group P had higher GRS compared with group S. The time to mark space, final success, US visibility score, Patient Comfort Scale score, procedural pain intensity, and patient satisfaction did not differ between the groups. One patient in group S developed a vasovagal reaction.
Discussion This study shows that prone position may be preferred for real-time US-TECP, considering its better clinical usefulness.
Trial registration number KCT0005757.
- Pain Management
- Pain, Postoperative
- Acute Pain
Data availability statement
Data are available upon reasonable request.
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Contributors SJS: conception, design, and conduct of the study; analysis and interpretation of data; reporting; and writing—original draft preparation. J-HL: conception, design, and conduct of the study; interpretation of data; writing—review, and editing of the manuscript. H-JK and IGL: data curation and acquisition. DHK, HMC, and S-MJ: planning, conception, and design of the study; supervision; and project administration. D-HK: planning, conception, design, and conduct of the study; writing—review, and editing of the manuscript; supervision; and project administration. All authors critically revised the manuscript. All authors approved the final version of the manuscript. D-HK (guarantor) accepts full responsibility for the finished work and/or the conduct of the study.
Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.
Competing interests None declared.
Provenance and peer review Not commissioned; externally peer reviewed.
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