Improving Labour Induction Analgesia: Epidural Fentanyl Bolus at Epidural Initiation for Induction of Labour
Status:
Terminated
Trial end date:
2020-11-02
Target enrollment:
Participant gender:
Summary
Labour pain can be intensified for labour inductions and women undergoing inductions often
have earlier and more frequent requests for analgesia. Current evidence suggests that
epidural analgesia effectively manages pain in labour, but may give rise to adverse effects
for both the mother and neonate. Opioids are often added to epidurals to improve the quality
of analgesia. Despite reassuring findings regarding epidural opioids, other investigators
have found an association between epidural opioids and neonatal respiratory distress, lower
Neurological and Adaptive Capacity scores, and reduced rates of breastfeeding. Given the
heightened implications for the mother and neonate in situations requiring induction of
labour, the desire for a positive outcome whilst still providing adequate maternal analgesia
is paramount.
This study thus aims to investigate whether a preliminary epidural Fentanyl bolus at the
initiation of the epidural may help to improve analgesia for women undergoing labour
inductions for post-term pregnancy in a safe manner. Importantly, the main rationale of this
proposed practice being that by achieving adequate epidural analgesia earlier in the labour
induction, this may lead to better pain control overall and less overall requirements for
epidural PCEA boluses and epidural "top-ups" as the induction progresses.
Phase:
Phase 1
Details
Lead Sponsor:
University of Saskatchewan
Treatments:
Analgesics, Opioid Anesthetics Anesthetics, Local Fentanyl