Anesthesia, Epidural Clinical Trial
Official title:
Programmed Intermittent Epidural Bolus Versus Continuous Epidural Infusion for Third Trimester Medical Termination of Pregnancy Analgesia : a Randomized Study.
Background : Recently, delivery of local anaesthetics via Programmed Intermittent Epidural
Bolus (PIEB) has been shown to improve labour epidural analgesia compared to delivery via
Continuous Epidural Infusion (CEI).
Purpose : However, the superiority of PIEB compared to CEI has not been investigated for
third trimester voluntary termination of pregnancy.
We hypothesized that PIEB administration would result in a better degree of satisfaction of
the patients compared with CEI for third trimester legally induced abortion analgesia.
Abstract : The recent technical advances in antenatal diagnosis have led to an increase
number of legally induced abortion at the third trimester of pregnancy. Psychological pain is
frequently associated to physical pain in these kinds of interventions. So anaesthetists are
more and more involved in voluntary termination of pregnancy analgesia.
In France, Patient Controlled Epidural Analgesia (PCEA) with CEI mode is usually used for
voluntary termination of pregnancy analgesia. But recent studies have shown that PIEB mode as
compared to CEI mode increases maternal satisfaction during labour. This may be attributed to
a more extensive spread of epidural solution when delivered as a bolus rather than continuous
infusion.
Few trials have been interested in investigating the best mode of PCEA for legally induced
abortion analgesia.
This study includes women who undergo voluntary third semester termination of pregnancy.
Patients are randomized to PIEB or CEI for pain analgesia. In this randomized, double-blind
study, the investigators assess the degree of satisfaction of the patients (primary outcome),
the incidence of motor block, total drug consumption and adverse events (secondary outcomes)
between the two study groups.
The different values are collected during the intervention on a specific paper for each
patient and the degree of satisfaction is reported on this paper just before the patient
leaves the birth room (approximatively 2 hours after the expulsion).
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