Labor Pain Clinical Trial
Official title:
Effect of Epidural Dexmedetomidine VS Nalbuphine for Labor Analgesia
Verified date | April 2022 |
Source | Ain Shams University |
Contact | n/a |
Is FDA regulated | No |
Health authority | |
Study type | Interventional |
The aim of this study is to compare epidural dexmedetomidine vs nalbuphine added to bupivacaine in labor analgesia and determine the privilege of one over the other and to compare the effect of both analgesics after delivery.
Status | Completed |
Enrollment | 64 |
Est. completion date | March 12, 2022 |
Est. primary completion date | February 12, 2022 |
Accepts healthy volunteers | No |
Gender | Female |
Age group | 21 Years to 40 Years |
Eligibility | Inclusion Criteria: All the parturients should : 1. Be between 21 - 40 years old 2. ASA classification I- II 3. Para 1-2 4. Requesting analgesia 5. Have a normal birth canal 6. Be at the beginning of active phase of labor i.e. cervical dilatation of 4 cm with regular uterine contractions. 7. The fetus should be a single full-term fetus (37- 42 weeks of gestation) with normal head position, normal development. Exclusion Criteria: Parturients 1. Younger than 21 and older than 40 years old 2. With contraindication of regional anesthesia 3. With pre-existing neurological disease 4. With history of allergy to the study drugs 5. With cephalopelvic disproportion, fetal distress, amniotic fluid infection, placental insufficiency or scarred uterus |
Country | Name | City | State |
---|---|---|---|
Egypt | Ain Shams University | Cairo |
Lead Sponsor | Collaborator |
---|---|
Ain Shams University |
Egypt,
Abdalla W, Ammar MA, Tharwat AI. Combination of dexmedetomidine and remifentanil for labor analgesia: A double-blinded, randomized, controlled study. Saudi J Anaesth. 2015 Oct-Dec;9(4):433-8. doi: 10.4103/1658-354X.159470. — View Citation
Aveline C, Bonnet F. [The effects of peridural anesthesia on duration of labor and mode of delivery]. Ann Fr Anesth Reanim. 2001 May;20(5):471-84. Review. French. — View Citation
Camann WR, Hurley RH, Gilbertson LI, Long ML, Datta S. Epidural nalbuphine for analgesia following caesarean delivery: dose-response and effect of local anaesthetic choice. Can J Anaesth. 1991 Sep;38(6):728-32. — View Citation
Chatrath V, Attri JP, Bala A, Khetarpal R, Ahuja D, Kaur S. Epidural nalbuphine for postoperative analgesia in orthopedic surgery. Anesth Essays Res. 2015 Sep-Dec;9(3):326-30. doi: 10.4103/0259-1162.158004. — View Citation
Czech I, Fuchs P, Fuchs A, Lorek M, Tobolska-Lorek D, Drosdzol-Cop A, Sikora J. Pharmacological and Non-Pharmacological Methods of Labour Pain Relief-Establishment of Effectiveness and Comparison. Int J Environ Res Public Health. 2018 Dec 9;15(12). pii: E2792. doi: 10.3390/ijerph15122792. — View Citation
Li N, Hu L, Li C, Pan X, Tang Y. Effect of Epidural Dexmedetomidine as an Adjuvant to Local Anesthetics for Labor Analgesia: A Meta-Analysis of Randomized Controlled Trials. Evid Based Complement Alternat Med. 2021 Oct 27;2021:4886970. doi: 10.1155/2021/4886970. eCollection 2021. Review. — View Citation
Wangping Z, Ming R. Optimal Dose of Epidural Dexmedetomidine Added to Ropivacaine for Epidural Labor Analgesia: A Pilot Study. Evid Based Complement Alternat Med. 2017;2017:7924148. doi: 10.1155/2017/7924148. Epub 2017 Jun 1. — View Citation
Type | Measure | Description | Time frame | Safety issue |
---|---|---|---|---|
Primary | change in VAS score for pain before analgesia and every 30 minutes after analgesia | The visual analog scale (VAS) is a tool widely used to measure pain. A patient is asked to indicate his/her perceived pain intensity along a 100 mm (10 cm) horizontal line, and this rating is then measured from the left edge (=VAS score). The VAS score correlates well with acute pain levels (Myles et al., 1999). Using a ruler, the score is determined by measuring the distance (cm) on the 10-cm line between the no pain anchor and the patients mark, providing a range of scores from 010. A higher score indicates greater pain intensity. | before analgesia and 30 minutes after analgesia and then every 30 minute as long as the epidural catheter is inserted (up to 360 minutes) | |
Secondary | change in Heart rate before analgesia and every 30 minutes after analgesia | Monitored and recorded | before analgesia and 30 minutes after analgesia and then every 30 minute as long as the epidural catheter is inserted (up to 360 minutes) | |
Secondary | change in arterial blood pressure before analgesia and every 30 minutes after analgesia | Monitored and recorded | before analgesia and 30 minutes after analgesia and then every 30 minute as long as the epidural catheter is inserted (up to 360 minutes) | |
Secondary | change in SpO2 before analgesia and every 30 minutes after analgesia | Monitored and recorded | before analgesia and 30 minutes after analgesia and then every 30 minute as long as the epidural catheter is inserted (up to 360 minutes) | |
Secondary | Duration of active phase of 1st stage of labor | The duration of active phase of 1st stage of labor varies from one to the other | from 100 minutes to 300 minutes | |
Secondary | Duration of 2nd stage of labor | The duration of 2nd stage of labor varies from one to the other | from 30 minutes to 200 minutes | |
Secondary | Duration of 3rd stage of labor | The duration of 3rd stage of labor varies from one to the other | from 5 minutes to 15 minutes | |
Secondary | Neonatal condition: APGAR score at 1 and 5 min after the birth | to check if any of the study drugs can deteriorate the neonatal condition | At 1 minute and 5 minutes after birth | |
Secondary | The adverse reactions: itching, nausea, vomiting, bradycardia and hypotension | These adverse reaction can occur after administration of the interventional drugs | As long as the epidural catheter is inserted (up to 360 minutes) |
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