Labor Pain
Conditions
Brief summary
Epidural anesthesia (EP) is widely used for labor analgesia. Time to onset of adequate pain relief of EP technique for labor analgesia may be 15 to 20 minutes.More rapid injection is often passible through the needle compared to catheter and could enhance the spread of medication within the epidural space.There is lack of research assessing the onset of labor analgesia with a large priming dose of local anesthetic through the epidural needle compared with the epidural catheter.
Detailed description
The epidural analgesia was performed in the left lateral decubitus position at the L3-L4 or L2-L3 interspace using a 18 G Tuohy needle. The epidural space was accessed by the loss of resistance to air or saline (2ml or less) technique. In the epidural needle group, after identification of epidural space, a dose of 3 ml of 0.1%ropivacaine with 0.3ug/ml sufentanil was given via the epidural needle ,3 minutes later labor analgesia was initiated with 15ml of 0.1 ropivacaine with 0.3ug/ml sufentanil over 30 seconds via the epidural needle, and then the catheter was inserted 3-5cm into the epidural space. In the epidural catheter group, the catheter was inserted 3-5cm into the epidural space after identification of epidural space, a dose of 3 ml of 0.1% ropivacaine with 0.3ug/ml sufentanil was given via the epidural catheter, 3minutes later labor analgesia was initiated with 15ml of 0.1%ropivacaine with 0.3ug/ml sufentanil as the same of group N.
Interventions
PROCEDUREepidural needle
the loading dose for labor analgesia administrated via epidural needle before the catheter insertion
PROCEDUREepidural catheter
the loading dose for labor analgesia administrated via epidural catheter
Sponsors
Women's Hospital School Of Medicine Zhejiang University
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
OTHER
Masking
TRIPLE (Subject, Investigator, Outcomes Assessor)
Eligibility
Sex/Gender
FEMALE
Age
20 Years to 40 Years
Healthy volunteers
No
Inclusion criteria
1. healthy, term (37-42 weeks' gestation), 2. nulliparous women with singleton 3. patients in active labor with a cervical dilation \<5cm who planned labor analgesia
Exclusion criteria
1. any contraindication to neuraxial anesthesia, 2. body mass index\>50kg/m2, 3. VAS \<50mm on a 100-mm visual analog pain scales during an active contraction, 4. pregnancy-related diseases (ie, gestational hypertension, gestational diabetes, and preeclampsia), 5\. the participants were in the event of an inadvertent dural puncture using the epidural needle, 6.fetal heart abnormity before labor analgesia.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| The time to onset of labor analgesia | 8 months | Compare time of onset of labor analgesia and adequate analgesia was defined as VAS score\<10mm in the presence of contraction. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| VSA scores | 8 months | the Visual Analog Scale (VAS) on a 100-mm scale is measured during the labor . |
| number of PCEA bolus requests | 8 months | the numbers of the patient -controlled epidural anangesia(PCEA) bolus of 5 ml with 15 minute lockout. |
| analgesia drug ( ropivacaine) requests | 8 months | The total ropivacaine dose is recorded and is divided by the hours. |
Countries
China
Outcome results
None listed