Determination of the Effective Volume of 0.125% Bupivacaine-fentanyl 5mcg/mL in Labour Epidurals

• Status: Completed
• Trial end date: 2014-04-01
• Target enrollment: 0
• Participant gender: Female

Summary

Different medications can be used as analgesics in labor epidurals. Bupivacaine is one of the most commonly used drugs for that purpose. The efficacy of a certain medication injected epidurally depends on the dose that is given. A certain dose can be administered in different concentrations, which will consequently mean different volumes. Studies have been done to determine volumes for different concentrations of bupivacaine. However, those studies fall short in the sense that this information cannot be readily applicable in clinical practice, as we don't use bupivacaine plain. The combination of bupivacaine and fentanyl or sufentanil is common practice, as it is well established that the opioids will reduce the concentration of local anesthetic required to produce optimal effect with the least side effects.

This study is being planned to determine and compare the EV90 of the bupivacaine 0.125%-fentanyl mixture for initiation of labor epidural analgesia, following the administration of the 2 different test doses (3cc of lidocaine 2% or 3cc of the bupivacaine 0.125%-fentanyl mixture) used in our Department.

• Phase: N/A
• Accepts Healthy Volunteers?: Accepts Healthy Volunteers

Details

• Lead Sponsor: Samuel Lunenfeld Research Institute, Mount Sinai Hospital
• Treatments: Bupivacaine; Fentanyl; Lidocaine

Criteria

Inclusion Criteria:

• ASA I or II

• Full term (minimum 37 weeks gestation)

• Singleton pregnancy, vertex presentation

• Regular painful contractions occurring at least every 5 minutes

• VAS Pain score at requesting analgesia > 5 (VNPS 0-10)

• Cervical dilatation < 5 cm

Exclusion Criteria:

• Refusal to provide written informed consent.

• Any contraindication to epidural anesthesia

• Accidental dural puncture

• Allergy or hypersensitivity to bupivacaine or fentanyl

• Use of opioids or sedatives within the last 4 hours.