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Epidural anesthesia (EP) is widely used for labor analgesia. Time to onset of adequate pain relief of EP technique for labor analgesia may be 15 to 20 minutes.More rapid injection is often passible through the needle compared to catheter and could enhance the spread of medication within the epidural space.There is lack of research assessing the onset of labor analgesia with a large priming dose of local anesthetic through the epidural needle compared with the epidural catheter.
The epidural analgesia was performed in the left lateral decubitus position at the L3-L4 or L2-L3 interspace using a 18 G Tuohy needle. The epidural space was accessed by the loss of resistance to air or saline (2ml or less) technique.
In the epidural needle group, after identification of epidural space, a dose of 3 ml of 0.1%ropivacaine with 0.3ug/ml sufentanil was given via the epidural needle ,3 minutes later labor analgesia was initiated with 15ml of 0.1 ropivacaine with 0.3ug/ml sufentanil over 30 seconds via the epidural needle, and then the catheter was inserted 3-5cm into the epidural space. In the epidural catheter group, the catheter was inserted 3-5cm into the epidural space after identification of epidural space, a dose of 3 ml of 0.1% ropivacaine with 0.3ug/ml sufentanil was given via the epidural catheter, 3minutes later labor analgesia was initiated with 15ml of 0.1%ropivacaine with 0.3ug/ml sufentanil as the same of group N.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| epidural needle | Experimental | the loading dose for labor analgesia administrated via epidural needle before the catheter insertion. |
|
| epidural catheter | Active Comparator | the loading dose for labor analgesia administrated via the epidural catheter. |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| epidural needle | Procedure | the loading dose for labor analgesia administrated via epidural needle before the catheter insertion |
|
| Measure | Description | Time Frame |
|---|---|---|
| The time to onset of labor analgesia | Compare time of onset of labor analgesia and adequate analgesia was defined as VAS score<10mm in the presence of contraction. | 8 months |
| Measure | Description | Time Frame |
|---|---|---|
| VSA scores | the Visual Analog Scale (VAS) on a 100-mm scale is measured during the labor . | 8 months |
| number of PCEA bolus requests | the numbers of the patient -controlled epidural anangesia(PCEA) bolus of 5 ml with 15 minute lockout. |
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Inclusion Criteria:
Exclusion Criteria:
5. the participants were in the event of an inadvertent dural puncture using the epidural needle, 6.fetal heart abnormity before labor analgesia.
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| Name | Affiliation | Role |
|---|---|---|
| Xinzhong Chen | Women's Hospital School Of Medicine Zhejiang University | Study Director |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Department of Anesthesiology, Women's Hospital, School of Medicine, Zhejiang University | Hangzhou | Zhejiang | 310000 | China |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 39744745 | Derived | Chen X, Tang Y, Yu Q, Sun L, Li H, Wang L, Jiao C, Chen X. Comparative study of labour analgesia onset with injection of loading dose through epidural needle versus catheter: A prospective, double-blinded, randomised clinical trial. Eur J Anaesthesiol. 2025 Feb 1;42(2):113-121. doi: 10.1097/EJA.0000000000002077. Epub 2024 Oct 16. |
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| ID | Term |
|---|---|
| D048949 | Labor Pain |
| ID | Term |
|---|---|
| D010146 | Pain |
| D009461 | Neurologic Manifestations |
| D012816 | Signs and Symptoms |
| D013568 | Pathological Conditions, Signs and Symptoms |
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| epidural catheter | Procedure | the loading dose for labor analgesia administrated via epidural catheter |
|
| 8 months |
| analgesia drug ( ropivacaine) requests | The total ropivacaine dose is recorded and is divided by the hours. | 8 months |