Pregnant Women>37SA
Conditions
Brief summary
The need to resort to a midwifery course work in cesarean is a common practice. Epidural analgesia for labor analgesia is practiced in 90% of women in obstetric work, as when the cesarean decision is taken course work in practice and the recommendations are to use the epidural catheter in place to convert the epidural analgesia in epidural anesthesia by re-injecting a local anesthetic on the catheter. General anesthesia is reserved only cases of extreme urgency and cons-indications for regional anesthesia as a purveyor of high maternal morbidity and mortality. The initial assumption is that the 2% lidocaine with epinephrine is the optimal and recommended local anesthetic solution.
Detailed description
There is a real variability in the volume administered by practitioners repository fault. The main objective is to determine the ED95 dose of 2% lidocaine with epinephrine injected into the epidural catheter for which it does not arise from failure to surgical anesthesia for cesarean during labor. The secondary objectives are to determine the failure risk factors, the hemodynamic consequences related to the volume administered and evaluate maternal satisfaction.
Interventions
Sponsors
University Hospital, Clermont-Ferrand
Study design
Allocation
NA
Intervention model
SINGLE_GROUP
Primary purpose
TREATMENT
Masking
NONE
Eligibility
Sex/Gender
FEMALE
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Pregnant \> 37SA * Between 150 and 190cm * IMC between 20 and 40 * Single pregnancy * Elective cesarean indication during obstetric labor
Exclusion criteria
* Presentation of siege * Extreme and semi emergency caesarean indication
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Success or failure of lidocaine 2% with epinephrine dose administered | at day 1 |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| maternal pain (Visual Analog Scale) | at day 1 | — |
| maternal satisfaction | at day 1 | — |
| nausea and vomiting intraoperatively | at day 1 | — |
| blood pressure (PAM, PAS (mmHg)) | at day 1 | — |
| fluid replacement (ml) | at day 1 | — |
| Study tolerance of epidural anesthesia for caesarean section | at day 1 | Study tolerance - including hemodynamics - of epidural anesthesia for caesarean section depending on the dose of 2% lidocaine with epinephrine administered. |
| necessary to use vasopressors | at day 1 | — |
| Apgar score | at day 1 | — |
| fetal arterial and venous cord pH | at day 1 | — |
| Intravenous sedation for inadequate anesthesia | at day 1 | — |
| hypotension | at day 1 | — |
Countries
France
Contacts
Primary ContactPatrick LACARIN
Outcome results
None listed