Pregnancy and Childbirth pan free normal vaginal delivery
Conditions
Sponsors
Faculty of Medicine
Eligibility
Sex/Gender
Female
Inclusion criteria
Inclusion criteria: Multipara woman, ASA physical status I or II, in active labor with engaged fetal head, term pregnancy of singleton fetus not in distress (Normal cardiotocography [baseline fetal heart rate between 110 and 160 beats/minute, baseline variability >5 beats/minute, presence of accelerations, and absence of decelerations], minimal cervical dilatation of at least 3 cm with intact membranes, those requiring oxytocin augmentation, cephalic presentation, and uncomplicated pregnancies.
Exclusion criteria
Exclusion criteria: Patients who refuse to participate, preexisting or pregnancy-induced hypertension, obesity, endocrine diseases, diagnosed fetal abnormalities, contra-indications to neuraxial anesthesia, occurrence of wet tap during epidural placement, fade of spinal analgesia & hence need for epidural activation, previous systemic opioid administrations, allergy to study agents, unconscious parturients, patients who are unable to communicate.
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| maternal VAS score;Time for the beginning of analgesia in each group (onset time).;The level of sensory block will be assessed using alcohol swabs on both sides of the body and the maximum level of sensory block ;The time from intrathecal injection to two dermatome sensory regression, sensory regression to S1 dermatome, and motor block regression to Bromage 1 ;Pain at the peak of a contraction ;pain score during the last contraction ;Duration of pain relief defined as the time from spinal injection to the first request for rescue analgesics or when the VAS is >3.and Time to first administration of supplemental analgesics (clinical duration);Highest sensory block to pin prick in the midline ;Motor block as assessed by the modified bromage scale;Fetal heart rate ;Apgar score ;Umbilical arterial blood gases ;neonatal heart rate | — |
Secondary
| Measure | Time frame |
|---|---|
| maternal adverse effects: respiratory depression ¿ Hypotension (and the need of ephedrine supplementation). . Nausea and vomiting, Shivering, Pruritus, respiratory depression, urine retention;Hemodynamic changes (pulse & blood pressure) 5, 10, 15, 20, 30, 60 and 120 minutes after block. Hemodynamic changes (pulse & blood pressure) ;fetal heart rate;maternal sedation state by modified Ramsay sedation score;maternal adverse to effects:nausea, vomiting, pruritis, respiratory depression, Shivering, urine retention, pistdural puncture headache, back pain, neurological damage | — |
Countries
Egypt
Contacts
Public Contactsabry abdallah
lecturer in aneaesthesia and intesnive care
Outcome results
None listed