Epidural Analgesia During Labour

NCT ID: NCT03133091

Last Updated: 2018-08-06

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

PHASE3

Total Enrollment

200 participants

Study Classification

INTERVENTIONAL

Study Start Date

2015-09-30

Study Completion Date

2017-09-30

Brief Summary

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Randomized single blind trial based on comparing the way the local anesthetic is dosificated during labour. The pain control is evaluated and compared with both dosage techniques (PCEA vs PIEB)using levobupivacaine and fentanyl. The primary objective is to see no differences in pain control(VAS, Visual Analog Scale). The secondary goals are the differences in motor block(Bromage Scale), satisfaction (Likert Scale), the outcome (eutocic, instrumental o cesarean section), second stage of labour time, newborn´s Apgar and pH and total dosis and secondary effects of local anesthetic.

Detailed Description

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There is a protocol where every healthy primiparous women have the chance to join the study after the explanation and the informed consent is signed. There are blind envelopes with the two kinds of treatment and the investigator only has to follow the protocol.

Conditions

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Anesthesia, Obstetrical Analgesia, Epidural

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

DOUBLE

Participants Investigators

Study Groups

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PIEB (Patient Intermittent Epidural Bolus)

PIEB: The boluses are programmed every 30 minutes. The patient can ask for another extra bolus in between if she wishes.

The dosis per hour are equivalent to the PCEA. We make a comparison between PCEA vs PIEB.

Group Type ACTIVE_COMPARATOR

PIEB: Patient Intermittent Epidural Boluses

Intervention Type DRUG

Each patient were randomized to PIEB (7 ml bolus every 30 minutes, with extra boluses (PCEA) of 6 ml every 20 minutes) or PCEA (5 ml in continuous perfussion + PCEA of 5 ml every 15 minutes).

PCEA (Patient continuous Epidural Analgesia)

PCEA: There is a continuous infusion and the patient can order extra boluses every 15 minutes.

The dosis per hour are equivalent to the other arm to the PIEB. We make a comparison between PCEA vs PIEB.

Group Type ACTIVE_COMPARATOR

PCEA: Patient Controlled Epidural Analgesia

Intervention Type DRUG

Each patient were randomized to PIEB (7 ml bolus every 30 minutes, with extra boluses (PCEA) of 6 ml every 20 minutes) or PCEA (5 ml in continuous perfussion + PCEA of 5 ml every 15 minutes).

Interventions

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PIEB: Patient Intermittent Epidural Boluses

Each patient were randomized to PIEB (7 ml bolus every 30 minutes, with extra boluses (PCEA) of 6 ml every 20 minutes) or PCEA (5 ml in continuous perfussion + PCEA of 5 ml every 15 minutes).

Intervention Type DRUG

PCEA: Patient Controlled Epidural Analgesia

Each patient were randomized to PIEB (7 ml bolus every 30 minutes, with extra boluses (PCEA) of 6 ml every 20 minutes) or PCEA (5 ml in continuous perfussion + PCEA of 5 ml every 15 minutes).

Intervention Type DRUG

Eligibility Criteria

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Inclusion Criteria

* 20- 40 years-old women
* Primiparous women
* Dilatation 3- 7 cm
* No risk illnesses for epidural block
* No risk pregnancy
* Signed informed consent

Exclusion Criteria

* Illnesses which are a risk for pregnancy
* Multiparous women
* Contraindicated diseases for epidural block
* Women who can not understand the procedure
* Women who do not want to sign the informed consent
* Patients with drug´s allergy
Minimum Eligible Age

20 Years

Maximum Eligible Age

40 Years

Eligible Sex

FEMALE

Accepts Healthy Volunteers

Yes

Sponsors

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Hospital del Rio Hortega

OTHER

Sponsor Role lead

Responsible Party

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MARIA BELEN RODRIGUEZ-CAMPOO

PhD title in Medicine and Surgery

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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M BELEN RODRIGUEZ-CAMPOO

Role: STUDY_DIRECTOR

Resident

Locations

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Hospital Universitario Rio Hortega

Valladolid, , Spain

Site Status

Countries

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Spain

References

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George RB, Allen TK, Habib AS. Intermittent epidural bolus compared with continuous epidural infusions for labor analgesia: a systematic review and meta-analysis. Anesth Analg. 2013 Jan;116(1):133-44. doi: 10.1213/ANE.0b013e3182713b26. Epub 2012 Dec 7.

Reference Type RESULT
PMID: 23223119 (View on PubMed)

Wong CA, Ratliff JT, Sullivan JT, Scavone BM, Toledo P, McCarthy RJ. A randomized comparison of programmed intermittent epidural bolus with continuous epidural infusion for labor analgesia. Anesth Analg. 2006 Mar;102(3):904-9. doi: 10.1213/01.ane.0000197778.57615.1a.

Reference Type RESULT
PMID: 16492849 (View on PubMed)

Capogna G, Camorcia M, Stirparo S, Farcomeni A. Programmed intermittent epidural bolus versus continuous epidural infusion for labor analgesia: the effects on maternal motor function and labor outcome. A randomized double-blind study in nulliparous women. Anesth Analg. 2011 Oct;113(4):826-31. doi: 10.1213/ANE.0b013e31822827b8. Epub 2011 Jul 25.

Reference Type RESULT
PMID: 21788309 (View on PubMed)

Chua SM, Sia AT. Automated intermittent epidural boluses improve analgesia induced by intrathecal fentanyl during labour. Can J Anaesth. 2004 Jun-Jul;51(6):581-5. doi: 10.1007/BF03018402.

Reference Type RESULT
PMID: 15197122 (View on PubMed)

Lin Y, Li Q, Liu J, Yang R, Liu J. Comparison of continuous epidural infusion and programmed intermittent epidural bolus in labor analgesia. Ther Clin Risk Manag. 2016 Jul 14;12:1107-12. doi: 10.2147/TCRM.S106021. eCollection 2016.

Reference Type RESULT
PMID: 27471390 (View on PubMed)

Halpern SH, Carvalho B. Patient-controlled epidural analgesia for labor. Anesth Analg. 2009 Mar;108(3):921-8. doi: 10.1213/ane.0b013e3181951a7f.

Reference Type RESULT
PMID: 19224805 (View on PubMed)

Gizzo S, Noventa M, Fagherazzi S, Lamparelli L, Ancona E, Di Gangi S, Saccardi C, D'Antona D, Nardelli GB. Update on best available options in obstetrics anaesthesia: perinatal outcomes, side effects and maternal satisfaction. Fifteen years systematic literature review. Arch Gynecol Obstet. 2014 Jul;290(1):21-34. doi: 10.1007/s00404-014-3212-x.

Reference Type RESULT
PMID: 24659334 (View on PubMed)

Melzack R. The myth of painless childbirth (the John J. Bonica lecture). Pain. 1984 Aug;19(4):321-337. doi: 10.1016/0304-3959(84)90079-4. No abstract available.

Reference Type RESULT
PMID: 6384895 (View on PubMed)

Hiltunen P, Raudaskoski T, Ebeling H, Moilanen I. Does pain relief during delivery decrease the risk of postnatal depression? Acta Obstet Gynecol Scand. 2004 Mar;83(3):257-61. doi: 10.1111/j.0001-6349.2004.0302.x.

Reference Type RESULT
PMID: 14995921 (View on PubMed)

Jones L, Othman M, Dowswell T, Alfirevic Z, Gates S, Newburn M, Jordan S, Lavender T, Neilson JP. Pain management for women in labour: an overview of systematic reviews. Cochrane Database Syst Rev. 2012 Mar 14;2012(3):CD009234. doi: 10.1002/14651858.CD009234.pub2.

Reference Type RESULT
PMID: 22419342 (View on PubMed)

Eriksen LM, Nohr EA, Kjaergaard H. Mode of delivery after epidural analgesia in a cohort of low-risk nulliparas. Birth. 2011 Dec;38(4):317-26. doi: 10.1111/j.1523-536X.2011.00486.x. Epub 2011 Sep 6.

Reference Type RESULT
PMID: 22112332 (View on PubMed)

Lieberman E, Lang JM, Cohen A, D'Agostino R Jr, Datta S, Frigoletto FD Jr. Association of epidural analgesia with cesarean delivery in nulliparas. Obstet Gynecol. 1996 Dec;88(6):993-1000. doi: 10.1016/s0029-7844(96)00359-6.

Reference Type RESULT
PMID: 8942841 (View on PubMed)

Patel RR, Peters TJ, Murphy DJ; ALSPAC Study Team. Prenatal risk factors for Caesarean section. Analyses of the ALSPAC cohort of 12,944 women in England. Int J Epidemiol. 2005 Apr;34(2):353-67. doi: 10.1093/ije/dyh401. Epub 2005 Jan 19.

Reference Type RESULT
PMID: 15659468 (View on PubMed)

Hjermstad MJ, Fayers PM, Haugen DF, Caraceni A, Hanks GW, Loge JH, Fainsinger R, Aass N, Kaasa S; European Palliative Care Research Collaborative (EPCRC). Studies comparing Numerical Rating Scales, Verbal Rating Scales, and Visual Analogue Scales for assessment of pain intensity in adults: a systematic literature review. J Pain Symptom Manage. 2011 Jun;41(6):1073-93. doi: 10.1016/j.jpainsymman.2010.08.016.

Reference Type RESULT
PMID: 21621130 (View on PubMed)

Rodriguez-Campoo MB, Curto A, Gonzalez M, Aldecoa C. Patient intermittent epidural boluses (PIEB) plus very low continuous epidural infusion (CEI) versus patient-controlled epidural analgesia (PCEA) plus continuous epidural infusion (CEI) in primiparous labour: a randomized trial. J Clin Monit Comput. 2019 Oct;33(5):879-885. doi: 10.1007/s10877-018-0229-x. Epub 2018 Nov 30.

Reference Type DERIVED
PMID: 30506299 (View on PubMed)

Other Identifiers

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290587

Identifier Type: -

Identifier Source: org_study_id

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