Development of Variable Volume Automated Mandatory Boluses for Patient-controlled Epidural Analgesia During Labour (VVAMB)
Labor Pain, Breakthrough Pain
About this trial
This is an interventional treatment trial for Labor Pain focused on measuring Labor Pain, Breakthrough Pain, Infusion pump
Eligibility Criteria
Inclusion Criteria:
- Healthy (American Society of Anesthesiologists (ASA) physical status 1 and 2) primiparous parturient at term (≥36 weeks gestation);
- Singleton fetus;
- In early labor stage (cervical dilation ≤5cm);
- Request labor epidural analgesia and able to administer combined spinal epidural analgesia (CSEA) according to protocol.
Exclusion Criteria:
- Non-cephalic fetal presentation;
- Obstetric (e.g. pre-eclampsia, premature rupture of amniotic membranes for more than 48 hours, gestational diabetes on insulin, pregnancy-induced hypertension on medication) and uncontrolled medical (e.g. cardiac disease) complications;
- Have contraindications to neuraxial blockade or have received parenteral opioids within last 2 hours;
- Dural puncture/ suspected dural puncture at initiation of CSEA.
Sites / Locations
- KK Women's and Children's HospitalRecruiting
Arms of the Study
Arm 1
Arm 2
Experimental
Active Comparator
Variable volume Automated Mandatory Bolus (VVAMB)
Automated mandatory bolus (AMB) of variable-frequency (VAMB)
The anaesthetic drug and pain medication are prepared in an epidural infusion pump with the VVAMB programme. The programme uses higher doses with lower frequency of medication (ropivacaine and fentanyl), and a patient control button for the patient to control the additional pain relief demands depending on the requirements during labour.
The anaesthetic drug and pain medication are prepared in an epidural infusion pump with the VAMB programme. The programme uses lower doses with more frequency of medication (ropivacaine and fentanyl), and a patient control button for the patient to control the additional pain relief demands depending on the requirements during labour.