Labor Pain
Conditions
Keywords
Analgesia nociception index, Painless labor, epidural analgesia
Brief summary
Epidural analgesia is considered an effective and safe method for obstetric pain control. Currently, self-assessment pain scales remain to be the gold standard in labor pain evaluation after the administration of epidural analgesia. However, individual patient susceptibility to pain perception makes difficulties for the clinicians to assess the effectiveness of painless labor precisely. The aim of this study is to evaluate the validity of ANI in obstetric pain monitoring during epidural analgesia.
Detailed description
Epidural analgesia is considered an effective and safe method for obstetric pain control. Currently, self-assessment pain scales remain to be the gold standard in labor pain evaluation after the administration of epidural analgesia. However, individual patient susceptibility to pain perception makes difficulties for the clinicians to assess the effectiveness of painless labor precisely. Without a convincing objective tool for obstetric pain evaluation during epidural analgesia, the clinicians are hard to adjust adequate epidural drug dosage. Establishing an objective pain index would help the clinicians to have a better pain management during labor. In 2012, M. Le Guen et al. demonstrated a linear relationship between visual analogical pain scores(VAS) and Analgesia Nociception Index (ANI) values during labor. Their efforts started the application of ANI in obstetric pain monitoring. However, the reliability of ANI in obstetric pain monitoring under epidural analgesia have not yet been verified. The aim of this study is to evaluate the validity of ANI in obstetric pain monitoring during epidural analgesia.
Interventions
Monitor the maternity with Analgesia nociception index
Sponsors
Changhua Christian Hospital
Study design
Observational model
CASE_ONLY
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
FEMALE
Age
20 Years to 50 Years
Healthy volunteers
No
Inclusion criteria
* Parturients with gestational age more than 35 weeks * Ages between 20 to 50 * Received epidural analgesia * American Society of Anesthesiologists classification I or II.
Exclusion criteria
* 1\. Who refused to join the study * 2\. With a history of arrhythmia * 3\. American Society of Anesthesiologists (ASA)Classification \>= III * 4\. With a history of cardiovascular, pulmonary, endocrine, neurologic or psychiatric disease * 5.Using medications that affecting heart rate * 6\. Cannot understand the explanation of the study * 7\. High-risk gestation * 8\. Known fetal anomaly
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| The correlation of subjective pain measurement by the VAS score and objective pain measurement by the ANI(Analgesia Nociception Index) score | 90 minutes | The VAS(visual analog scale) score is a subjective measure for pain. Scores are recorded by making a handwritten mark by the patient on a 10-cm line that represents a continuum between no pain and worst pain. The score will be transferred to a 0-100 index by divided 10 with the distance from the starting point to the written mark (in centimeter) and multiplied by 100. The ANI (Analgesia Nociception Index) score is a 0-100 index derived from heart rate variability which was applied as an objective pain measurement. The larger the index indicated less pain. The correlation of the VAS score and the ANI score will be analyzed to verified the strength of the ANI score in evaluating labor pain during epidural analgesia. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| The correlation of uterine contraction strength measured by cardiotocography and the ANI (Analgesia Nociception Index) score | 90 Minutes | Uterine contraction strength was measured by external cardiotocography with a scare from 0-100.The ANI (Analgesia Nociception Index) score is a 0-100 index derived from heart rate variability which was applied as an objective pain measurement. The larger the index indicated less pain. The correlation of the uterine contraction strength and the ANI score will be analyzed to verified if the ANI score changing with related to uterine contraction. |
Countries
Taiwan
Contacts
Primary ContactMin-Ling Chen, MD
Outcome results
None listed