A Comparison Between 2 Methods of Local Anesthetic Administration for Maintaining Labor Analgesia After Dural Puncture Epidural

NCT ID: NCT05034211

Last Updated: 2021-09-05

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

UNKNOWN

Clinical Phase

NA

Total Enrollment

100 participants

Study Classification

INTERVENTIONAL

Study Start Date

2021-10-01

Study Completion Date

2022-06-01

Brief Summary

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Intermittent epidural bolus technique opens a new era of interest for maintaining labor anlagesia. The study examines programmed intermittent epidural bolus technique on a scheduled basis to provider-administered bolus anlgesia on patient request, after a dural puncture epidural technique.

Detailed Description

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After dural puncture, an epidural catheter will be placed on nulliparous women between 38 and 40 weeks of gestation presenting for labor . All will receive an test dose of 3ml lidocaine 2%, for properly checking the catheter placement and then an initial dose of 10ml ropivacaine 0,2% with 2 mcg/ml fentanyl. After that, women will be randomly assigned on two groups. Both groups will be receiving the same dose of analgesia (10ml ropivacaine 0,2% plus 1,5 mcg/ml fentanyl. However, one group will be receiving them on scheduled time intervals as programmed intermittent boluses every 60minutes and the other only on patient request for pain relief.

Pain scores, satisfaction, time for adequate analgesia, bromage scores,apgar scores, fetal arterial blood gases, time for delivery and type of delivery will be studied

Conditions

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Labor Pain Epidural Pain, Labor

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

QUADRUPLE

Participants Caregivers Investigators Outcome Assessors

Study Groups

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Programmed intermittent Bolus Epidural technique

10ml ropivacaine 0,2% and 1,5 mcg/ml fentanyl, will be administered every 60 minutes via an epidural catheter placed for labor analgesia on L2-L3/L3-L4 level

Group Type ACTIVE_COMPARATOR

Programmed intermittent bolus epidural

Intervention Type PROCEDURE

one arm will receive programmed intermittent boluses of local anesthetic via the epidural catheter on fixed time intervals. Standard 27G Tuohy needle epidural set with epidural catheter insertion on L2-L3 site, with the patient either sitting or in the lateral decubitus position will be used. Local injection with 6 ml lidocaine 2% will be performed before the insertion of the epidural needle

Provider administered bolus epidural technique on patient request

10ml ropivacaine 0,2% and 1,5 mcg/ml fentanyl, will be administered by the provider on patient request

Group Type ACTIVE_COMPARATOR

Provider administered analgesia on patient request

Intervention Type PROCEDURE

one arm will receive bolus of local anesthetic via the catheter upon patient request. Standard 27G Tuohy needle epidural set with epidural catheter insertion on L2-L3 site, with the patient either sitting or in the lateral decubitus position will be used. Local injection with 6 ml lidocaine 2% will be performed before the insertion of the epidural needle

Interventions

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Programmed intermittent bolus epidural

one arm will receive programmed intermittent boluses of local anesthetic via the epidural catheter on fixed time intervals. Standard 27G Tuohy needle epidural set with epidural catheter insertion on L2-L3 site, with the patient either sitting or in the lateral decubitus position will be used. Local injection with 6 ml lidocaine 2% will be performed before the insertion of the epidural needle

Intervention Type PROCEDURE

Provider administered analgesia on patient request

one arm will receive bolus of local anesthetic via the catheter upon patient request. Standard 27G Tuohy needle epidural set with epidural catheter insertion on L2-L3 site, with the patient either sitting or in the lateral decubitus position will be used. Local injection with 6 ml lidocaine 2% will be performed before the insertion of the epidural needle

Intervention Type PROCEDURE

Eligibility Criteria

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Inclusion Criteria

-nulliparous women

* 38th week of gestation

Exclusion Criteria

* patient refusal to have an epidural
* patient refusal to participate
* contraindication for epidural
* ASA\>3
* neurologic deficit/impairment
* allergy on local anesthetic chronic pain syndromes
Minimum Eligible Age

20 Years

Maximum Eligible Age

43 Years

Eligible Sex

FEMALE

Accepts Healthy Volunteers

Yes

Sponsors

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Aretaieio Hospital

OTHER

Sponsor Role lead

Responsible Party

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Polyxeni Theodosopoulou

Resident anesthesiologist

Responsibility Role PRINCIPAL_INVESTIGATOR

Locations

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Aretaieio Hospital

Athens, Attica, Greece

Site Status RECRUITING

Countries

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Greece

Central Contacts

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Anteia Paraskeva, Dr

Role: CONTACT

306972868078

Polyxeni Theodosopoulou, MD

Role: CONTACT

Facility Contacts

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Anteia Paraskeva, Dr

Role: primary

Polyxeni Theodosopoulou, MD

Role: backup

Other Identifiers

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342/25/5/21

Identifier Type: -

Identifier Source: org_study_id

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