Ultrasound Versus Palpation for Epidural Catheterization
Ultrasound Versus Palpation for Epidural Catheterization
The study will assess the benefit of using spinal ultrasound before epidural catheter
 insertion compared to the conventional palpation technique in women undergoing cesarean
 section.
The study will compare the ultrasound-assisted and the conventional palpation techniques for
 epidural catheterization as a component of combined spinal-epidural anesthesia for cesarean
 section.

 Participants will be randomly assigned into 2 equal groups. In the ultrasound group:
 Preprocedure lumbar spinal ultrasound will be performed before epidural catheterization. In
 the palpation group: Conventional technique of landmark palpation will be used.
Inclusion Criteria:

 -  American Society of Anesthesiologists class I or II.

 -  Full term parturients scheduled for elective cesarean delivery under combined
 spinal-epidural anesthesia.

 Exclusion Criteria:

 -  Body mass index ≥ 35 kg/m2.

 -  Patients having any contraindication to neuraxial anesthesia (Refusal of the
 procedure, Coagulopathy, Uncorrected hypovolemia, Increased intracranial pressure,
 Local skin infection).

 -  Marked spinal deformity or previous spinal surgery.

 -  Unpalpable anatomical landmarks.

 -  Emergent situations.