Programmed Intermittent Epidural Bolus Versus Continuous Infusion When Added to Patient-controlled Epidural Analgesia on Bupivacaine Consumption in Labour Analgesia: a Randomized Controlled Trial
Overview
- Phase
- Not Applicable
- Intervention
- Not specified
- Conditions
- Labor Pain
- Sponsor
- Université de Sherbrooke
- Enrollment
- 200
- Locations
- 1
- Primary Endpoint
- Dose of bupivacaine in milligrams per hour
- Status
- Recruiting
- Last Updated
- 2 years ago
Overview
Brief Summary
This study aims to establish if programmed intermittent epidural bolus combined to patient controlled analgesia in labour analgesia will lower the hourly bupivacaine consumption when compared to continuous infusion combined with patient controlled analgesia. The investigators' hypothesis is that the use of programmed intermittent epidural bolus will lower the hourly bupivacaine consumption.
Detailed Description
Patients are randomised to receive either a programmed bolus of 6ml each 45 minutes or a continuous infusion of 8ml/h. In each group, they have the possibility to add a PCEA bolus of 6ml every 20min as needed.
Investigators
Geneviève Rivard
Principal investigator
Université de Sherbrooke
Eligibility Criteria
Inclusion Criteria
- •Pregnant nulliparous or multiparous woman in labour
- •Age ≥18 years
- •Obtained consent for epidural analgesia
- •ASA classification I-II-III
- •Early labour (cervical dilation ≤6cm)
Exclusion Criteria
- •Pregnancy-related comorbidities (preeclampsia, eclampsia, gestational diabetes, large for gestational age fetus)
- •Prematurity (\<36 weeks of gestation)
- •Multiple gestation
- •Fentanyl allergy or hypersensitivity
- •Patient unable to understand the PCEA
- •Fetal breech position
- •Maternal cardiac pathology and contraindication to Valsalva manoeuvre
- •Patient with a pain visual analog scale (VAS) not ≤1/10 20 minutes after the anesthesiologist's initial bolus
- •Intrathecal catheter or intravascular catheter
- •Accidental dural puncture
Outcomes
Primary Outcomes
Dose of bupivacaine in milligrams per hour
Time Frame: 1 day
Total dose of bupivacaine in milligrams divided by the total duration of the epidural in hours
Secondary Outcomes
- Time lapse before the first PCEA request after the epidural connection(1 day)
- First stage(1 day)
- Evaluation of pain(1 day)
- Assisted vaginal delivery(1 day)
- PCEA boluses requested(1 day)
- Second stage(1 day)
- Cesarean section(1 day)
- Anesthesiologist manual bolus(1 day)
- PCEA boluses received(1 day)
- Patient satisfaction(1 day)
- Motor blockade(1 day)