Estimation of Pain During Epidural Analgesia During Labor (PERIDANS)

September 15, 2015 updated by: Centre Hospitalier Universitaire de Saint Etienne

Estimation of Pain During Epidural Analgesia During Labor - a Monocentric Study

Epidural regional anesthesia is a technique to eliminate or lessen pain during obstetric labor and childbirth. It consists in establishing a catheter into the epidural space and to block the transmission of pain sensations by injecting a local anesthetic and an opioid. In 10-25% of cases the epidural does not give perfect results, causing it to test its effectiveness, which is mainly done by questioning the patient on mitigation or disappearance of pain. This collaboration of patients is sometimes limited in our care structure by the inability to assess or express the pain, mainly due to cultural differences or language barriers, which can represent up to 15% of women in our institution. This led to develop objective measures of pain techniques used at the bedside.

Pupil diameter (PD) varies under the double influence of sympathetic system (Σ), dilator of the pupil, and parasympathetic system (pΣ).

The PD increases in response to painful stimulation, in proportion to the intensity of the nociceptive stimulus. This variation of PD has been proposed as a means of evaluation of pain in patients under general anesthesia, but has been little studied in conscious subjects.

There are other permanent changes in the PD, due to constant interaction between Σ and pΣ systems. Few data have been published to date on this PD variability (PDV).

Study Overview

Status

Completed

Conditions

Intervention / Treatment

Study Type

Interventional

Enrollment (Actual)

40

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

  • France
      • Saint-Etienne, France, 42055
        • CHU Saint-etienne

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 to 45 years (Adult)

Accepts Healthy Volunteers

No

Genders Eligible for Study

Female

Description

Inclusion Criteria:

  • Obstetrical Labor
  • Able to rate their pain using VAS
  • dilatation of the cervix under 6 centimeters
  • Written consent

Exclusion Criteria:

  • - Not having a anesthesia consultation during the 48 hours before delivery
  • With a contra-indication for an epidural
  • To which an incident occurred during a previous epidural using a medication used in the study
  • Operated a unilateral or bilateral ocular surgery modifying the possibilities of variation of pupil diameter
  • general anesthesia in the seven days preceding delivery
  • Carry a pacemaker or heart grafted
  • Having Parkinson's disease history, insulin or non-insulin diabetes or chronic alcoholism
  • Having cardiac arrhythmia (atrial fibrillation or frequent extrasystoles)
  • Treated for hypertension by receptor antagonists of angiotensin type 2
  • anti-arrhythmic treatment or blocker,
  • Refusing to participate in the study
  • With a contra-indication for the use of ropivacaine and sufentanil.

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: Prevention
  • Allocation: N/A
  • Interventional Model: Single Group Assignment
  • Masking: None (Open Label)

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
Experimental: Patients

Pain assess by :

  • Visual Analogic Scale (VAS).
  • Portable video pupillometer
Device: Portable video pupillometer
Portable video pupillometer measures pupil diameter (PD) in patient during obstetrical labor

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Pupil diameter variability
Time Frame: From baseline to fifteen minutes after start of Epidural regional anesthesia
Compare Pupil Diameter Variability (PDV) measured before Epidural regional anesthesia and after Epidural regional anesthesia. PDV is aera under the curve of Pupil Diameter from start of the contraction (baseline) to time to peak of the contraction.
From baseline to fifteen minutes after start of Epidural regional anesthesia

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
pupil diameter
Time Frame: From baseline to fifteen minutes after start of Epidural regional anesthesia
Compare the Pupil Diameter measured five seconds after time to peak of contraction before Epidural regional anesthesia and after Epidural regional anesthesia
From baseline to fifteen minutes after start of Epidural regional anesthesia
Visual Analogic Scale (VAS)
Time Frame: From baseline to fifteen minutes after start of Epidural regional anesthesia
Compare the VAS measured at the end of contraction before Epidural regional anesthesia and after Epidural regional anesthesia.
From baseline to fifteen minutes after start of Epidural regional anesthesia

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Centre Hospitalier Universitaire de Saint Etienne

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

November 1, 2012

Primary Completion (Actual)

March 1, 2013

Study Completion (Actual)

March 1, 2013

Study Registration Dates

First Submitted

September 11, 2015

First Submitted That Met QC Criteria

September 15, 2015

First Posted (Estimate)

September 16, 2015

Study Record Updates

Last Update Posted (Estimate)

September 16, 2015

Last Update Submitted That Met QC Criteria

September 15, 2015

Last Verified

September 1, 2015

More Information

Terms related to this study

Keywords

Other Study ID Numbers

  • 1208078

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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