- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT01860521
Programmed Intermittent Epidural Bolus Versus Continuous Epidural Infusion for Termination of Pregnancy Analgesia
August 19, 2013 updated by: Umberto Leone Roberti Maggiore, IRCCS Azienda Ospedaliera Universitaria San Martino - IST Istituto Nazionale per la Ricerca sul Cancro, Genoa, Italy
Programmed Intermittent Epidural Bolus Versus Continuous Epidural Infusion for Second Trimester Voluntary Termination of Pregnancy Analgesia: a Randomized Study.
This study included women who underwent voluntary second trimester termination of pregnancy.
Patients were randomized to programmed intermittent epidural anesthetic bolus or continuous epidural infusion for pain analgesia.
In this randomized, double-blind study, the investigators assess the incidence of motor block (primary outcome), degree of satisfaction of the patients, total levobupivacaine and sufentanil consumption and adverse events (secondary outcomes) between the two study groups.
Study Overview
Status
Completed
Conditions
Intervention / Treatment
- Procedure: Programmed Intermittent Epidural Bolus
- Procedure: Procedure of interruption of pregnancy
- Drug: Drug used for analgesia procedures
- Device: Pump for programmed intermittent bolus.
- Drug: Drug used for termination of pregnancy procedure.
- Procedure: Continuous Epidural Infusion
- Device: Pump for continuous epidural infusion.
Study Type
Interventional
Enrollment (Actual)
104
Phase
- Not Applicable
Contacts and Locations
This section provides the contact details for those conducting the study, and information on where this study is being conducted.
Study Locations
-
-
Ligury
-
Genoa, Ligury, Italy, 16132
- Department of Obstetrics and Gynecology, San Martino Hospital and National Institute for Cancer Research, University of Genoa
-
-
Participation Criteria
Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.
Eligibility Criteria
Ages Eligible for Study
18 years and older (Adult, Older Adult)
Accepts Healthy Volunteers
No
Genders Eligible for Study
Female
Description
Inclusion Criteria:
- age ≥ 18 years
- pregnancy at second trimester
- willingness of voluntary interrupt the pregnancy
- comprehension of Italian Language
- baseline pain score ≥ 30 on a 100-mm visual analog pain scale (VAPS)
Exclusion Criteria:
- contraindication to epidural analgesia and to narcotics
- history of drug abuse or chronic use
- maternal disease (such as severe asthma, cardiac, liver or kidney disease)
- inability to comprehend or comply with the analgesia pain management procedures.
Study Plan
This section provides details of the study plan, including how the study is designed and what the study is measuring.
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: Quadruple
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
Active Comparator: Programmed Intermittent Epidural Bolus
|
An initial epidural loading dose consisting of 0.0625% levobupivacaine 20 mL (Chirocaine®, Abbott, Chicago, USA) plus sufentanil 10 µg (Fentatienil®, Angelini, Rome, Italy) was followed by 0.0625% levobupivacaine with sufentanil 0.5 µg/mL, 10 mL every hour, starting 60 minutes after the administration of the initial epidural loading dose until expulsion of the fetus.
If the patient still felt pain (VAPS score ≥ 30mm), despite the analgesia, additional manual incremental boluses of 5-mL levobupivacaine 0.125% until the VAPS score was < 30 mm were administered.
Patients were administered 1 mg of gemeprost pessaries (Cervidil®, Merck Serono SPA, Roma, Italy) in the posterior fornix of the vagina every 3 hours up to 5 doses.
If the expulsion of the fetus did not occur, the therapeutic regimen was repeated after 24 hours from the initiation of the treatment.
Induction-to-abortion time (hours) was considered the period of time comprised between the first gemeprost pessary administration and fetal expulsion.
Failure of induction of abortion was defined as women undelivered after two completed cycles (48h).The evacuation of the uterus under general anesthesia was performed if ultrasonography showed retained productions of conception.
Levobupivacaine (Chirocaine®, Abbott, Chicago, IL, USA) and sufentanil(Fentatienil®, Angelini, Rome, Italy) were administered in both study groups according to the regimen of each intervention arm (Programmed Intermittent Epidural Bolus Versus Continuous Epidural Infusion).
Other Names:
Pump administering programmed intermittent epidural bolus for the maintenance of analgesia was used.
Other Names:
Gemeprost pessaries.
Other Names:
|
Active Comparator: Continuous Epidural Infusion
|
Patients were administered 1 mg of gemeprost pessaries (Cervidil®, Merck Serono SPA, Roma, Italy) in the posterior fornix of the vagina every 3 hours up to 5 doses.
If the expulsion of the fetus did not occur, the therapeutic regimen was repeated after 24 hours from the initiation of the treatment.
Induction-to-abortion time (hours) was considered the period of time comprised between the first gemeprost pessary administration and fetal expulsion.
Failure of induction of abortion was defined as women undelivered after two completed cycles (48h).The evacuation of the uterus under general anesthesia was performed if ultrasonography showed retained productions of conception.
Levobupivacaine (Chirocaine®, Abbott, Chicago, IL, USA) and sufentanil(Fentatienil®, Angelini, Rome, Italy) were administered in both study groups according to the regimen of each intervention arm (Programmed Intermittent Epidural Bolus Versus Continuous Epidural Infusion).
Other Names:
Gemeprost pessaries.
Other Names:
An initial epidural loading dose consisting of 0.0625% levobupivacaine 20 mL (Chirocaine®, Abbott, Chicago, USA) plus sufentanil 10 µg (Fentatienil®, Angelini, Rome, Italy) was followed by 0.0625% levobupivacaine with sufentanil 0.5 µg/mL at a rate of 10 mL/h, starting 60 minutes after the administration of the initial epidural loading dose until expulsion of the fetus.
If the patient still felt pain (VAPS score ≥ 30mm), despite the analgesia, additional manual incremental boluses of 5-mL levobupivacaine 0.125% until the VAPS score was < 30 mm were administered.
Pump administering continuous epidural infusion for the maintenance of analgesia was used.
Other Names:
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Incidence of Motor Block
Time Frame: Assessed every hour from starting the analgesia procedure (up to 66 hours from starting of the procedure).
|
The assessment of the degree of motor block was performed in the right and left lower extremities using the Breen modified Bromage score: 1 = complete block (unable to move feet or knees), 2 = almost complete block (able to move feet only), 3 = partial block (just able to move knees), 4 = detectable weakness of hip flexion while supine (between scores 3 and 5), 5 = no detectable weakness of hip flexion while supine (full flexion of knees), and 6 = able to stand and to perform partial knee bend.
Patients with a Bromage score < 6 were considered to have motor block.
|
Assessed every hour from starting the analgesia procedure (up to 66 hours from starting of the procedure).
|
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Degree of Satisfaction of the Patients With the Analgesia Procedure
Time Frame: At discharge from the hospital (up to 72 hours from starting of the procedure).
|
At discharge from the hospital, patients were requested to answer the following question "Taking into consideration the variations in pain symptoms, as well as the adverse events experienced, if any, how would you define the grade of satisfaction with your analgesic treatment?"
The grade of satisfaction was assessed using a visual analog scale (VAS) where 0 corresponded to "completely unsatisfied" and 100 to "completely satisfied".
|
At discharge from the hospital (up to 72 hours from starting of the procedure).
|
Total Levobupivacaine Consumption
Time Frame: At the moment of fetal expulsion (up to 66 hours from starting of the procedure).
|
At the moment of fetal expulsion (up to 66 hours from starting of the procedure).
|
|
Total Sufentanil Consumption.
Time Frame: During the whole analgesia procedure (assessed between the starting of the procedure until 66 hours).
|
During the whole analgesia procedure (assessed between the starting of the procedure until 66 hours).
|
Collaborators and Investigators
This is where you will find people and organizations involved with this study.
Investigators
- Study Director: Simone Ferrero, PhD, Università degli Studi di Genova
- Principal Investigator: Umberto Leone Roberti Maggiore, MD, Università degli Studi di Genova
Study record dates
These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.
Study Major Dates
Study Start
September 1, 2011
Primary Completion (Actual)
June 1, 2013
Study Completion (Actual)
June 1, 2013
Study Registration Dates
First Submitted
May 13, 2013
First Submitted That Met QC Criteria
May 20, 2013
First Posted (Estimate)
May 22, 2013
Study Record Updates
Last Update Posted (Estimate)
October 28, 2013
Last Update Submitted That Met QC Criteria
August 19, 2013
Last Verified
August 1, 2013
More Information
Terms related to this study
Keywords
Additional Relevant MeSH Terms
- Physiological Effects of Drugs
- Central Nervous System Depressants
- Peripheral Nervous System Agents
- Analgesics
- Sensory System Agents
- Anesthetics, Intravenous
- Anesthetics, General
- Anesthetics
- Analgesics, Opioid
- Narcotics
- Adjuvants, Anesthesia
- Anesthetics, Local
- Reproductive Control Agents
- Abortifacient Agents, Nonsteroidal
- Abortifacient Agents
- Levobupivacaine
- Sufentanil
- Gemeprost
Other Study ID Numbers
- SCUL 4022
This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.
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