Effect of Programmed Intermittent Epidural Bolus Delivery Rate on the Quality of Labour Analgesia: A Randomized Clinical Trial
Overview
- Phase
- Phase 4
- Intervention
- Bupivacaine 0.08% - fentanyl 2mcg
- Conditions
- Labor Pain
- Sponsor
- University of British Columbia
- Enrollment
- 390
- Locations
- 1
- Primary Endpoint
- Breakthrough pain
- Status
- Completed
- Last Updated
- 5 years ago
Overview
Brief Summary
Comparison of three programmed intermittent epidural bolus (PIEB) pump settings for maintenance of labour analgesia.
Detailed Description
The optimal PIEB and patient controlled epidural administered (PCEA) bolus settings are still unknown. Therefore, in this study, the investigators aim to compare analgesia outcomes both high and low PIEB flow rate settings.
Investigators
Anthony Chau
Clinical Assistant Professor
University of British Columbia
Eligibility Criteria
Inclusion Criteria
- •Singleton, vertex presentations at term (37-42 weeks gestational age)
- •\</= 5cm cervical dilation at the time of epidural anesthesia request
- •ASA 2-3 patients aged 19 or over who are able to provide informed consent
Exclusion Criteria
- •Contraindications to neuraxial analgesia or risk factors likely to affect placement or function of the epidural
- •History of hypersensitivity or idiosyncratic reaction to local anesthetics or opioids
- •Current or historical evidence of any significant medical conditions
- •Clinical settings in which continuous epidural infusion may be preferable
- •Risk factors significantly increasing the need for Cesarean delivery
- •Anticipated fetal abnormalities
Arms & Interventions
Group A
Bupivacaine 0.08% - fentanyl 2mcg on the following pump settings: PIEB flow rate = high; interval = 60 min
Intervention: Bupivacaine 0.08% - fentanyl 2mcg
Group B
Bupivacaine 0.08% - fentanyl 2mcg on the following pump settin PIEB flow rate = high; interval = 45 min
Intervention: Bupivacaine 0.08% - fentanyl 2mcg
Group C
Bupivacaine 0.08% - fentanyl 2mcg on the following pump settin PIEB flow rate = low; interval = 45 min
Intervention: Bupivacaine 0.08% - fentanyl 2mcg
Outcomes
Primary Outcomes
Breakthrough pain
Time Frame: Duration of labor with epidural
Proportion of patients in each group who required a provider administered supplemental bolus for breakthrough pain