Comparison of labor analgesia efficacy between single-orifice and multiorifice wire-reinforced catheters during programmed intermittent epidural boluses: a randomized controlled clinical trial

Yi, Juan; Li, Yujie; Yuan, Yawei; Xu, Zhendong; Song, Yujie; Ye, Binglu; Zhao, Qingsong; Yang, Yingying; Du, Weijia; Liu, Zhiqiang

doi:10.1136/rapm-2022-103723

Cited by 4 publications

(3 citation statements)

References 21 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Thus, the percentage of sufficient analgesia 15 min after the initial volume is selected as the primary outcome, which is similar to a recent study. 24 …”

Section: Discussionmentioning

confidence: 99%

“…Because the fetal heart monitoring can be diverse in the whole stages of labor owing to the complex personal situation, and studies have shown that epidural analgesia has little statistical influence on fetal heart rate, we will not analyze it. 5 , 19 , 24 However, we will collect the apgar score to evaluate the security of neonates.…”

Section: Discussionmentioning

confidence: 99%

“…Thus, the percentage of sufficient analgesia 15 min after the initial volume is selected as the primary outcome, which is similar to a recent study. 24 To eliminate the interference from unsuccessful cases, the NRS scores, sensory blocking level and blocking symmetry will be examined 30 min after initial dose. Yet, there is still no standard definition of epidural labor analgesia failure.…”

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

The Effects of Different Puncture Points on Labor Analgesia Onset: Study Protocol for a Randomized Controlled Trial

Zhou,

Peng,

Chen

et al. 2023

JPR

View full text Add to dashboard Cite

Purpose Parturients suffer severe pain during the stages of labor, especially the first and second. Epidural anesthesia is an effective method to alleviate labor pain. L2-3, L3-4 and L4-5 spaces have been reported to be the recommendable puncture points owing to the adequate analgesia effect and high safety. However, the speed of pain alleviation via the three points has hardly been determined, which is of great importance to parturients. Thus, the aim of this study is to compare the onset time of parturients’ painless uterine contraction after epidural labor analgesia through different puncture points. Study Design and Methods It is a prospective, randomized, controlled, and subject- and assessor-blinded study. Totally, 150 subjects scheduled for vaginal delivery are going to be randomly assigned into the L2-3 and L3-4 group. Puncture point in L2-3 group is lumbar 2–3 space, while in L3-4 group it is lumbar 3–4 space. Analgesia initiation and maintenance are the same between the two groups. Primary outcome will be percentage of painless uterine contraction 15 min after epidural labor analgesia initiation. Secondary outcomes will be the sensory blocking level, motor blocking score, adverse effects of parturients, drug liquid consumption in unit interval, apgar score and degree of satisfaction of the parturients. Discussion This study estimates the onset time of parturients’ painless uterine contraction after epidural labor analgesia through L2-3 or L3-4 space. The results may provide a better choice to relieve labor pain as soon as possible.

show abstract

“…Thus, the percentage of sufficient analgesia 15 min after the initial volume is selected as the primary outcome, which is similar to a recent study. 24 …”

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

The Effects of Different Puncture Points on Labor Analgesia Onset: Study Protocol for a Randomized Controlled Trial

Zhou,

Peng,

Chen

et al. 2023

JPR

View full text Add to dashboard Cite

show abstract

Role of lumbar puncture level on the onset of epidural labor analgesia: a randomized controlled trial

Zhou,

Cao,

Chen

et al. 2024

Postgraduate Medical Journal

View full text Add to dashboard Cite

ObjectiveTo compare the speed of achieving painless uterine contractions in parturients undergoing epidural analgesia at different lumbar puncture levels.MethodsThis study is a randomized controlled trial at a tertiary A hospital with a history of over 80 years in Sichuan Province, China. Parturients aged 22–40 years old scheduled for vaginal delivery under epidural analgesia were recruited. Eligible patients were randomly allocated into lumbar 2-3 (L2-3) or lumbar 3-4 (L3-4) groups. Epidural analgesia was performed through the interspaces according to grouping. The primary outcome was the percentage of painless uterine contractions 15 min after the initiation of analgesia. The secondary outcomes included the percentage of painless status at 5 and 10 min, sensory block plane, motor block evaluation, adverse events of parturients, epidural analgesic consumption, Apgar score, and the parturients' evaluation of analgesia.ResultsBetween April 2023 and August 2023, a total of 150 women were finally recruited, and 136 of them were analyzed (68 in each group). In comparison with the L3-4 groups, there was a significantly larger proportion of painless uterine contractions at 5, 10, and 15 min after analgesia initiation in the L2-3 group (20.6% vs. 7.4%, 52.9% vs. 26.5%, and 80.9% vs. 64.7%, P = .026, .002, and .034, respectively). Similarly, the pain scores were lower in the L2-3 group at 5, 10, and 15 min than that in the L3-4 group (5(4,7) vs. 6(5,7), 3(2,5) vs. 4(3,6), and 2(1,3) vs. 3(2,5), P = .006, .004, and .020, respectively). Furthermore, puncturing through the L2-3 interspace contributed to a higher evaluation of parturients to the analgesia procedure (9(8,9) vs. 8(8,9), P < .001). However, there was no significant difference in sensory block, motor block, or adverse events between the two groups.ConclusionPuncturing through the L2-3 interspace is associated with faster pain relief and a better experience for parturients. These findings present a superior option for anesthesiologists when conducting epidural labor analgesia.Key messages What is already known on this topic? Epidural analgesia is an effective way to relieve labor pain. What this study adds? Puncturing via lumbar 2-3 interspace induces more rapid onset of epidural analgesia. How this study might affect research, practice or policy? Lumbar 2-3 interspace is a superior option in terms of the speed of pain relief and satisfaction of parturients when conducting epidural labor analgesia.

show abstract

Comparative study of labour analgesia onset with injection of loading dose through epidural needle versus catheter

Chen,

Tang,

et al. 2024

European Journal of Anaesthesiology

View full text Add to dashboard Cite

BACKGROUND Rapid onset of epidural analgesia is an important concern for the parturient. Commonly, the local anaesthetic mixture is administered through the epidural catheter. Drugs administered through the epidural needle might decrease the onset time and enhance the spread of medication within the epidural space. OBJECTIVES The primary aim of this study was to compare the onset time of analgesia when a loading dose of dilute local anaesthetic opioid mixture was injected through either the Tuohy needle or a single end-hole epidural catheter. DESIGN A prospective, double-blinded, randomised clinical trial. SETTING Single university hospital, from November 2022 to August 2023. PARTICIPANTS A total of 200 healthy nulliparous women who requested epidural analgesia for labour were randomly allocated to the needle group (n = 100) or the catheter group (n = 100). INTERVENTIONS In the needle group, after identification of the epidural space, a test dose of 3 ml 0.1% ropivacaine with 0.3 μg ml−1 sufentanil was injected through the Tuohy needle followed 3 min later by a 15 ml loading dose of the same mixture over 30 s. Then the catheter was inserted into the epidural space. In the catheter group, after identification of the epidural space, a catheter was advanced into the epidural space and the ropivacaine/sufentanil mixture was injected in an identical manner though the catheter. MAIN OUTCOME MEARSURES The primary outcome was the onset time of labour analgesia (defined as the time from drug administration to adequate analgesia). Adequate analgesia was defined as a visual analogue score 10 mm or less during uterine contractions. RESULTS Median [IQR] onset time of labour analgesia did not differ significantly between the two groups (needle group: 20 [16 to 30] minutes; catheter group: 20 [15 to 25] minutes, P = 0.232). CONCLUSION Compared with bolus injection though a single end-hole epidural catheter, injection through the epidural needle did not shorten the analgesia onset time for adequate labour analgesia. TRIAL REGISTRATION ClinicalTrials.gov (NCT05594771).

show abstract

Comparison of labor analgesia efficacy between single-orifice and multiorifice wire-reinforced catheters during programmed intermittent epidural boluses: a randomized controlled clinical trial

Cited by 4 publications

References 21 publications

The Effects of Different Puncture Points on Labor Analgesia Onset: Study Protocol for a Randomized Controlled Trial

The Effects of Different Puncture Points on Labor Analgesia Onset: Study Protocol for a Randomized Controlled Trial

Role of lumbar puncture level on the onset of epidural labor analgesia: a randomized controlled trial

Comparative study of labour analgesia onset with injection of loading dose through epidural needle versus catheter

Contact Info

Product

Resources

About