Sixteen million babies were born in 2010, approximately half were by cesarean. Labor analgesia should be the first choice for these parturients based on the consideration of security and humanization. However this labor analgesia rate is quite low in China (\<5%) while in western country, this rate is up to 60%. Programmed intermittent epidural bolus (PIEB) is the latest technique for labor analgesia which has less neurotoxicity theoretically compared with Continuous Epidural Infusion(CEI) with Patient controlled epidural analgesia (PCEA) which is used most commonly. In that study, they reported less total local anesthetic consumption, fewer manual bolus doses and greater patient satisfaction with the PIEB technique. In China, multiple factors contribute to the reasons of low labor analgesia rate. From the patient's point of view, worrying about unsatisfied analgesia, and not adapted to the symptoms of motor block, such as inability to move their legs distressing, both are important reasons of refusing labor analgesia and preferring to cesarean delivery. Therefore, in this clinical trial, we plan to find a safer and more effective regimen for labor analgesia in Chineseparturients. This clinical trial is designed to prove PIEB used Ropivacaine is safer and more effective than CEI for labor analgesia in Chinese parturients.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
DOUBLE
Enrollment
186
Obstetrics and Gynecology Hospital Affiliated to Nanjing Medical University
Nanjing, Jiangsu, China
RECRUITINGMaternal visual analogue scale (VAS)
a visual analog scale (VAS) with a 10 cm vertical score ranged from "no pain" to "worst possible pain"
Time frame: At time of initiation of analgesia and hourly thereafter until 1 hours postpartum (approximately 10 hours)
Maternal modified Bromage scale
Time frame: At time of initiation of analgesia and hourly thereafter until 2 hours postpartum (approximately 10 hours)
Subject's Satisfaction with labor epidural analgesia
Time frame: At the time after childbirth
Total ropivacaine and sufentanil consumption
Time frame: At two hours postpartum
Proportion of parturients requiring additional PCEA boluses
Time frame: At two hours postpartum
Rate of "very satisfied"and/or "satisfied",Proportion of subjects who has experienced Visual analog scale (VAS) score for pain more than 3 scale
Time frame: At two hours postpartum
Maternal heart rate
Time frame: At time of initiation of analgesia and hourly thereafter until 4 hours postpartum (approximately 12 hours)
Rates of cesarean delivery and instrument-assisted delivery
Time frame: At time of placental delivery
Duration of analgesia
Time frame: Initiation of analgesia to 2 h postpartum (approximately 10 hours)
Durations of labor stages
Time frame: From the beginning of regular contraction of uterus to the end of the labor (approximately 12 hours)
Use of oxytocin after analgesia
Time frame: At twenty-four hours postpartum
Incidence of maternal side effects
Time frame: Initiation of analgesia to 2 hour postpartum (approximately 10 hours)
Neonatal Apgar scale
Time frame: At the first and fifth minutes after baby was born
Fetal heart rate
Time frame: From initiation of analgesia to delivery (approximately 8 hours)
Neonatal weight
Time frame: At delivery
Mean number of PCEA
Time frame: At two hours postpartum
Maternal respiratory rate
Time frame: At time of initiation of analgesia and hourly thereafter until 4 hours postpartum (approximately 12 hours)
Maternal blood pressure
Time frame: At time of initiation of analgesia and hourly thereafter until 4 hours postpartum (approximately 12 hours)
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