To assess the efficacy of epidural dexamethasone administration, compared to placebo, in reducing local anesthetics consumption during labor epidural analgesia in parturient women
It is hypothesized that reducing the consumption of local anesthetics during labor epidural analgesia could lower their side effects (rate of motor block, nausea and emesis during labor, maternal hypotension, maternal fever) and improve the duration of the second part of the labor, and the new-born adaptation to child-birth and during the first 24 hours. The use of instruments for assisted vaginal delivery and the needs to perform emergency cesarean could also be impacted. The efficacy of the dexamethasone will be assessed by the hourly Ropivacaine consumption (milligrams/hour) measured from randomization time to the end of epidural analgesia.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
DOUBLE
single epidural injection of dexamethasone (8 mg) in addition to local anesthetics used for epidural analgesia
single epidural injection of sodium chloride 0.9% (2 mL) in addition to local anesthetics used for epidural analgesia
NAROPEINE 7.5 mg/mL is diluted at the concentration of 1 mg/mL prior to the epidural use. The perfused dose depends on the efficacy of analgesia in reducing the delivery labor pain.
Hourly ropivacaine consumption expressed as mg/mL used during epidural analgesia in parturient women
The administered dose of ropivacaine during epidural is used to measure the efficacy of Dexamethasone in reducing local anesthetics during labor analgesia
Time frame: From the beginning to the end of epidural analgesia, that could last up to 6 hours
Improvement of epidural analgesia assessed by the reduction of adverse effects induced by local anesthetics
Adverse effects such as nausea and emesis, maternal hypotension, maternal hyperthermia will be recorded during epidural analgesia
Time frame: From the beginning to the end of epidural analgesia, that could last up to 6 hours
Dexamethasone effect maternal pain during delivery assessed by Visual Analogic Scale
Evaluation of the lowered maternal pain induced by Dexamethasone
Time frame: From the beginning to the end of epidural analgesia, that could last up to 6 hours
Improvement of delivery assessed by recording the number of side events (motor block, emergency cesarean, instrument-assisted delivery)
Rates of motor block, emergency cesarean, instrument-assisted delivery
Time frame: From the beginning to the end of epidural analgesia, that could last up to 6 hours
Maternal satisfaction assessed by visual analogic scale
Patient satisfaction visual analogic scale
Time frame: On the morning of the next day after delivery, up to 24 hours
This platform is for informational purposes only and does not constitute medical advice. Always consult a qualified healthcare professional.
Sufentanil 0.5 mg/L is used as solution for injection for epidural analgesia and used in combination with ropivacaine. The administered dose is bolus of 15 to 20 micrograms diluted into 10 mL.