ArticleJA clinical reports2020
Distinguishing cerebrospinal fluid from mepivacaine using the pH test in patients undergoing elective cesarean section with combined spinal-epidural anesthesia.
Article in JA clinical reports, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
2 citing papers in PubMed, 4 citations in OpenAlex.
- The significance of different intervertebral spaces in combined spinal epidural anesthesia in cesarean section.Technology and health care : official journal of the European Society for Engineering and Medicine · 2024Trial
- Repeat spinal anesthesia for intrapartum cesarean section after epidural labor analgesia: a retrospective cohort study of failure rate and the volume-risk relationship.BMC anesthesiology · 2026Article
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Authors and funding
3 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionIn single-space combined spinal-epidural anesthesia (CSEA), it is important to correctly determine if the fluid coming out of the spinal needle is cerebrospinal fluid (CSF) or the liquid used in the loss of resistance (LOR) technique. In this study, we used mepivacaine for LOR and measured the pH values of CSF and mepivacaine to determine whether the pH test is a reliable method to confirm CSF when performing single-space CSEA.
methodsThis clinical trial included 47 full-term pregnant women who underwent cesarean section. Single-space CSEA was administered at the lumbar intervertebral space using a small amount of mepivacaine for LOR. The pH values of CSF and mepivacaine were determined by the color of the test strip immediately after dropping. The area under the curve (AUC) for the pH values was calculated to determine the cutoff value for distinguishing between CSF and mepivacaine.
resultsThe median pH values were 7.7 (7.1-8.0) and 6.2 (5.9-6.8) for CSF and mepivacaine, respectively. When the cutoff value of pH for distinguishing CSF from mepivacaine was 7.1 or greater, the AUC was 1.0 (100% sensitivity and specificity). Our result demonstrated that CSF can be correctly distinguished from mepivacaine in patients undergoing cesarean section under single-space CSEA using a cutoff value of pH 7.1.
conclusionThe pH test is a simple and reliable method to confirm CSF when performing single-space CSEA with mepivacaine for LOR.
trial registrationAccuracy of pH test paper for cerebrospinal fluid during spinal anesthesia: prospective study in healthy pregnant women under scheduled caesarean section; University Hospital Medical Information Network, UMIN000036454 . Registered 1 May 2019.
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