Bicarbonate Epidural Injection in Emergency Caesarian

NCT ID: NCT04255121

Last Updated: 2021-03-01

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

400 participants

Study Classification

INTERVENTIONAL

Study Start Date

2020-06-22

Study Completion Date

2021-02-26

Brief Summary

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During labor, pain is systematic. In France, epidural analgesia is the gold standard to fight pain.

Sometimes, emergency situations involve the maternal or fetal prognosis and require an emergency fetal extraction by caesarean. When an effective epidural analgesia is in place, an injection of adrenaline lidocaine converts this epidural analgesia into an epidural anesthesia allowing a surgical procedure. Sometimes, the time required to set up the anesthesia cannot be expected and a general anesthesia is performed.

Local anesthetics used during epidural analgesia have Pka between 7.8 and 8.1. In solution, local anesthetics exist in two forms: an un-ionized form and an ionized form. The non-ionized form is liposoluble and crosses the lipid membranes to reach the site of intracellular action. The non-ionized form conditions the time taken to install anesthesia.

When the pH of the solution is equal to Pka, un-ionized and ionized form are present in equal quantity. Commercial local anesthetic solutions have acidic pH and so contained a majority of ionized form. Alkalinization of local anesthetics solution should bring the pH closer to pKa and therefore to favor a greater proportion of non-ionized form.

Detailed Description

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The aim of this study is to evaluate impact of an alkalinization of adrenaline lidocaine solution for conversion of epidural analgesia into epidural anesthesia during an emergency caesarean.

Conditions

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Emergency Caesarean

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

DOUBLE

Participants Outcome Assessors

Study Groups

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alkalinization of adrenaline lidocaine solution arm

conversion of epidural analgesia into epidural anesthesia during an emergency caesarean using an alkalinization of adrenaline lidocaine solution

Group Type EXPERIMENTAL

2% adrenaline lidocaine associated with 4.2% sodium bicarbonate

Intervention Type DRUG

conversion of epidural analgesia into epidural anesthesia during an emergency caesarean using an alkalinization of adrenaline lidocaine solution

adrenaline lidocaine solution arm

conversion of epidural analgesia into epidural anesthesia during an emergency caesarean using a adrenaline lidocaine solution

Group Type ACTIVE_COMPARATOR

2% adrenaline lidocaine

Intervention Type DRUG

conversion of epidural analgesia into epidural anesthesia during an emergency caesarean using an adrenaline lidocaine solution

Interventions

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2% adrenaline lidocaine associated with 4.2% sodium bicarbonate

conversion of epidural analgesia into epidural anesthesia during an emergency caesarean using an alkalinization of adrenaline lidocaine solution

Intervention Type DRUG

2% adrenaline lidocaine

conversion of epidural analgesia into epidural anesthesia during an emergency caesarean using an adrenaline lidocaine solution

Intervention Type DRUG

Eligibility Criteria

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Inclusion Criteria

* pregnant women followed up in the Reims University Hospital
* women whose birth is expected by vaginal delivery in the Reims University Hospital
* women wishing to benefit from epidural analgesia
* women agreeing to participate in the research and having signed informed consent
* women aged 18 years old and more
* women affiliated to a social security system

Exclusion Criteria

* women who don't benefit from emergency caesarian (vaginal delivery or scheduled caesarian)
* women for whom epidural analgesia cannot be used
* women for whom epidural analgesia is not effective
Minimum Eligible Age

18 Years

Eligible Sex

FEMALE

Accepts Healthy Volunteers

No

Sponsors

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CHU de Reims

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Locations

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Chu Reims

Reims, , France

Site Status

Countries

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France

Other Identifiers

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PO19144*

Identifier Type: -

Identifier Source: org_study_id

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