Efficacy of Labor Epidurals for Postpartum Tubal Ligation
Efficacy of Labor Epidurals for Postpartum Tubal Ligation
The goal of this study is to evaluate the effect of continuous postpartum epidural saline
 infusion on the reactivation of labor epidurals for postpartum tubal ligation surgery
 following vaginal delivery.
The aim of this research is to determine the effect of postpartum epidural saline infusion on
 the reactivation of labor epidural catheters which are used as the anesthetic technique for
 PPTL following vaginal delivery. It is proposed that continuous epidural saline infusion will
 decrease the incidence of catheter obstruction by preventing clot, fibrosis, or tissue
 plugging and therefore improve reactivation rates. To our knowledge, this is a novel method
 for attempting to improve epidural reactivation rate and if successful, it would challenge
 the current practice of only capping epidurals following delivery and later attempting
 reactivation prior to PPTL. This may, possibly, become a new technique used to improve the
 rate of epidural reactivation for PPTL.

 If study results show improved labor epidural reactivation rates, benefits would include
 decreased patient morbidity and greater patient comfort and satisfaction by avoiding the
 risks of additional neuraxial procedures as well as general anesthesia. These risks include
 difficult or failed intubation, aspiration, hypotension, headache, postoperative nausea and
 vomiting, and sore throat. Improving epidural reactivation rate could also result in greater
 OR efficiency and decreased costs for the patient and hospital.

 The investigators also hope to elucidate factors associated with catheter migration or
 dislodgement and subsequent failure of epidural reactivation. Additionally, we hope to
 determine what effect obesity and length of time prior epidural reactivation have on epidural
 reactivation rates.
Inclusion Criteria:

 -  Pregnant women

 -  18 to 45 years of age

 -  Admitted to MUSC in labor or for induction of labor resulting in a vaginal delivery
 epidural analgesia

 -  Postpartum tubal ligation following delivery

 -  American Society of Anesthesiologists (ASA) Physical Class 1, 2, and 3

 Exclusion Criteria:

 -  Critically Ill Patients (patients admitted to the ICU)

 -  Cognitively Impaired Persons (patients with a diagnosis of cognitive deficit)

 -  Cesarean delivery

 -  Punctured dura

 -  Patients enrolled in other epidural research studies