This study explores the potential for a more rapid onset of pain relief when drug administration is performed through the epidural needle, a technique of epidural loading that provides a rapid and reliable level of labor analgesia without the disadvantages of a combined spinal-epidural, and could add a valuable new tool to anesthesiologists.
This study explores the potential for a more rapid onset of pain relief when drug administration is performed through the epidural needle, a technique of epidural loading that provides a rapid and reliable level of labor analgesia without the disadvantages of a combined spinal-epidural, and could add a valuable new tool to anesthesiologists. Investigators propose to conduct a single blinded, randomized controlled trial to determine if a difference exists in the speed of onset and spread of labor analgesia between patients receiving an epidural loading dose through the epidural needle or catheter. Group 1 (Epidural Catheter Administration) participants will receive the 10 mL epidural loading dose in 5 mL increments via the epidural catheter following catheter placement (current standard practice). Group 2 (Epidural Needle Administration ) participants will receive the 10 mL epidural loading dose in 5 mL increments via the epidural needle prior to catheter placement (experimental group). Various parameters will be measured in the time after drug administration to evaluate blood pressure, heart rate, and fetal heart rate. Following delivery, the total anesthetic dose, total number of doses demanded, total number and dosage of rescue doses, and overall patient satisfaction will be recorded.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
SINGLE
Labor epidural analgesia loading dose
Epidural loading dose via epidural catheter
Epidural loading dose via epidural needle
The Ohio State University Wexner Medical Center
Columbus, Ohio, United States
Mean VAS pain score
Mean VAS pain score will be determined 20 minutes following epidural loading, including assessments at 5, 10, 15, and 20 minutes.
Time frame: 20 minutes
Analgesic level
Analgesic level assessed by pinprick at 10, 15 and 20 minutes following loading
Time frame: 10, 15, and 20 minutes
Maternal Blood Pressure
Change in maternal blood pressure loading
Time frame: Baseline and 20 minutes
Fetal Heart Rate
Change in fetal heart rate over 20 minutes following loading
Time frame: Baseline and 20 minutes
Rescue Bolus Count
Number of rescue bolus doses will be counted
Time frame: During Labor
Analgesia Satisfaction
Overall patient satisfaction with analgesia following delivery via questionnaire
Time frame: During labor
Intravascular catheter placement
Incidence of intravascular catheter placement
Time frame: During labor
Total anesthetic dose required
The total anesthetic dose during labor will be calculated
Time frame: During Labor
Maternal Heart Rate
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Change in maternal heart rate
Time frame: Baseline and 20 minutes