Vaginal Delivery Clinical Trial
Official title:
Failed Epidural Anesthesia During Labor: Evaluation of Risk Factors and Impact on Labor ,Maternal and Fetal Outcomes
Women requesting epidural analgesia will receive a bolus of intravenous infusion of lactated
Ringer's solution before initiation of the procedure. An 18-gauge Tuohy needle and closed-tip
clear catheter with three lateral orifices (Portex, Smith Medical, Hythe, UK) were used in
the sitting or lateral position, with a loss-of-resistance to air technique. Epidural
catheters will be inserted 5-6 cm inside the epidural space. A test dose of 2 ml of lidocaine
2% iss initiated followed by a loading dose of 10 ml of bupivacaine 0.25%. Analgesia is
established and maintained throughout labor and delivery using 0.125% bupivacaine with
fentanyl 2 μg/ml with patient-controlled epidural analgesia by means of a continuous epidural
infusion (8 ml/h basal rate) and patient-controlled boluses (3 ml each) with 20-minlock-out
intervals, continued at the same bolus dose until delivery.
Pain was evaluated using a 0-10 cm visual analogue scale (VAS) before, 15 and 30 min after
the loading dose followed by hourly assessment until delivery. VAS score assessment was based
specifically on abdominal or back pain resulting from contractions
Status | Recruiting |
Enrollment | 500 |
Est. completion date | February 2018 |
Est. primary completion date | December 2017 |
Accepts healthy volunteers | No |
Gender | Female |
Age group | 19 Years to 40 Years |
Eligibility |
Inclusion Criteria: - =34 weeks of gestation - receiving epidural analgesia during labor, Exclusion Criteria: - Women who had a planned cesarean delivery, - intrauterine fetal death - non-vertex presentation - delivered at less than 30 min after epidural insertion - contraindication for epidural analgesia (i.e., thrombocytopenia <100,000 cells/µl, ongoing thromboprophylaxis with low-molecular-weight or unfractionated heparin, and bacteremia or infection at the needle-puncture site) |
Country | Name | City | State |
---|---|---|---|
Egypt | Ahmed Maged | Cairo |
Lead Sponsor | Collaborator |
---|---|
Cairo University |
Egypt,
Type | Measure | Description | Time frame | Safety issue |
---|---|---|---|---|
Primary | duration of first stage of labor | effect of success and failure of epidural on duration of first stage of labor (..before, 15 and 30 min after the loading dose followed by hourly assessment until delivery..) | from start of cervical dilatation till full cervical dilatation |
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