Comparison of labor analgesia efficacy between single-orifice and multiorifice wire-reinforced catheters during programmed intermittent epidural boluses: a randomized controlled clinical trial.
Reg Anesth Pain Med
; 48(2): 61-66, 2023 02.
Article
em En
| MEDLINE
| ID: mdl-36351740
ABSTRACT
AIMS:
We compared analgesic outcomes between single-orifice and multiorifice wire-reinforced catheters under 480 mL/hour delivery rate with programmed intermittent epidural bolus administration.METHODS:
Between August and November 2021, 182 nulliparous and healthy women with singleton pregnancy, 2-5 cm cervical dilation, and requesting neuraxial analgesia were randomized to receive either single-orifice or multiorifice catheters. Epidural analgesia was initiated and maintained with 0.1% ropivacaine and 0.3 µg/mL sufentanil. Programmed intermittent epidural bolus volume of 10 mL was administered every 45 min at 480 mL/hour beginning immediately after the test dose. Primary outcome was the percentage of parturients in the two groups with adequate analgesia 20 min after the initial bolus.RESULTS:
Compared with multiorifice catheters, single-orifice catheters were associated with a higher proportion of parturients with adequate analgesia (71.8% vs 56.0%, respectively; 95% CI 1.3% to 29%, p=0.03) and more frequent S2 sensory blockade (37.6% vs 22.6%, respectively; 95% CI -30% to 1%, p=0.03) 20 min after block initiation. Median time (IQR) to adequate analgesia was 12 (8-30) min and 20 (10-47) min with single-orifice and multiorifice catheters, respectively (95% CI 0.1 to 0.7 min, p<0.01). The median (IQR) ropivacaine consumption per hour was higher in parturients receiving multiorifice catheters than those with single-orifice catheters (15.3 (13.3-17.0) mg/hour vs 13.3 (13.3-15.4) mg/hour, respectively; 95% CI 0.2 to 0.8 mg/hour, p<0.001).CONCLUSION:
Single-orifice catheters used for programmed intermittent epidural bolus at 480 mL/hour for epidural labor analgesia had improved analgesic efficacy than multiorifice catheters. TRIAL REGISTRATION NUMBER ChiCTR2100049872.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Analgesia Epidural
/
Analgesia Obstétrica
Tipo de estudo:
Clinical_trials
Limite:
Female
/
Humans
/
Pregnancy
Idioma:
En
Revista:
Reg Anesth Pain Med
Assunto da revista:
ANESTESIOLOGIA
/
NEUROLOGIA
/
PSICOFISIOLOGIA
Ano de publicação:
2023
Tipo de documento:
Article
País de afiliação:
China