Estimation of Pain During Epidural Analgesia During Labor (PERIDANS)
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).
Aperçu de l'étude
Statut
Les conditions
Intervention / Traitement
Type d'étude
Inscription (Réel)
Phase
- N'est pas applicable
Contacts et emplacements
Lieux d'étude
-
-
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Saint-Etienne, France, 42055
- Chu Saint-Etienne
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-
Critères de participation
Critère d'éligibilité
Âges éligibles pour étudier
Accepte les volontaires sains
Sexes éligibles pour l'étude
La 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.
Plan d'étude
Comment l'étude est-elle conçue ?
Détails de conception
- Objectif principal: La prévention
- Répartition: N / A
- Modèle interventionnel: Affectation à un seul groupe
- Masquage: Aucun (étiquette ouverte)
Armes et Interventions
Groupe de participants / Bras |
Intervention / Traitement |
|---|---|
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Expérimental: Patients
Pain assess by :
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Portable video pupillometer measures pupil diameter (PD) in patient during obstetrical labor
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Que mesure l'étude ?
Principaux critères de jugement
Mesure des résultats |
Description de la mesure |
Délai |
|---|---|---|
|
Pupil diameter variability
Délai: 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.
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From baseline to fifteen minutes after start of Epidural regional anesthesia
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Mesures de résultats secondaires
Mesure des résultats |
Description de la mesure |
Délai |
|---|---|---|
|
pupil diameter
Délai: 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
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From baseline to fifteen minutes after start of Epidural regional anesthesia
|
|
Visual Analogic Scale (VAS)
Délai: 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.
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From baseline to fifteen minutes after start of Epidural regional anesthesia
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Collaborateurs et enquêteurs
Dates d'enregistrement des études
Dates principales de l'étude
Début de l'étude
Achèvement primaire (Réel)
Achèvement de l'étude (Réel)
Dates d'inscription aux études
Première soumission
Première soumission répondant aux critères de contrôle qualité
Première publication (Estimation)
Mises à jour des dossiers d'étude
Dernière mise à jour publiée (Estimation)
Dernière mise à jour soumise répondant aux critères de contrôle qualité
Dernière vérification
Plus d'information
Termes liés à cette étude
Autres numéros d'identification d'étude
- 1208078
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