Intrathecal Catheter Placement Versus Resiting Epidural Catheter After Dural Puncture in Obstetric Patients
NCT05977361 · Status: NOT_YET_RECRUITING · Phase: NA · Type: INTERVENTIONAL · Enrollment: 181
Last updated 2024-04-25
Summary
Epidural anesthesia represents the most popular method for pain relief during labour. Unintentional dural puncture (UDP) occurs in 0.4-1.5% of labour epidural analgesia, representing therefore the most common complication. Up to 80% of patients with a UDP may develop a post-dural puncture headache (PDPH).
When a UDP occurs, two possible strategies have been proposed in order to ensure analgesia during labour: either resiting the epidural catheter in a different intervertebral space, or inserting an intrathecal catheter. Both strategies proved to equally provide analgesia during labour, but their relative contribution in preventing PDPH is still not known.
The primary aim of this multicenter randomized controlled trial is therefore to compare these two strategies in the occurrence of PDPH at 24 hours from the UDP.
Conditions
- Analgesia, Obstetrical
- Post-Dural Puncture Headache
Interventions
- PROCEDURE
-
Resiting Epidural Catheter
After a UDP has occurred, epidural catheter will be re-sited in a different intervertebral space. Analgesia will be then maintained according to internal protocol, using PIEB (Programmed Intermittent Epidural Bolus) system. Catheter will be left in place for the first 24-36 hours.
- PROCEDURE
-
Intrathecal Catheter Placement
After a UDP has occurred, an intrathecal catheter will be placed through the dural tap. Analgesia will be then maintained according to internal protocol, using PISB (Programmed Intermittent Subarachnoid Bolus) system. Catheter will be left in place for the first 24-36 hours. During this time, a continuous infusion of sterile saline at a rate of 2 mL/h will be maintained. Before removal, an additional bolus of 10 mL of sterile saline will be administered in the intrathecal catheter.
Sponsors & Collaborators
-
Fondazione Policlinico Universitario Agostino Gemelli IRCCS
lead OTHER
Study Design
- Allocation
- RANDOMIZED
- Purpose
- TREATMENT
- Masking
- NONE
- Model
- PARALLEL
Eligibility
- Min Age
- 18 Years
- Sex
- FEMALE
- Healthy Volunteers
- No
Timeline & Regulatory
- Start
- 2024-04-26
- Primary Completion
- 2026-11-30
- Completion
- 2026-11-30
More Related Trials
-
Ultrasound Predictors of Difficulty in Performing Epidural Anesthesia for Labor in Pregnant Patients.
NCT07056166 ·Status: RECRUITING
-
Epidural vs. Dural Puncture Epidural in Labor Analgesia
NCT06849726 ·Status: COMPLETED ·Phase: NA
-
Combined Spinal Epidural Urinary Retention
NCT01597791 ·Status: TERMINATED ·Phase: NA
-
A Comparison Study Of Two Different Techniques For Identifying The Epidural Space In Parturients In Labour
NCT01574391 ·Status: COMPLETED ·Phase: NA
-
A Comparison Between 2 Methods of Local Anesthetic Administration for Maintaining Labor Analgesia After Dural Puncture Epidural
NCT05034211 ·Status: UNKNOWN ·Phase: NA
-
Assessment of Catheter Flow Direction Using Color Flow Doppler in Labor Epidurals
NCT05126745 ·Status: COMPLETED
-
Different Spinal Needles Sizes and Dural Puncture Epidural For Labor Analgesia
NCT03389945 ·Status: COMPLETED ·Phase: NA
-
Comparison of Dural Puncture Epidural Versus Conventional Epidural for Labour Analgesia in Primigravida
NCT06766812 ·Status: NOT_YET_RECRUITING ·Phase: NA
-
Does Ultrasound Help With Placement of Labor Analgesia in Pregnant Patients?
NCT02207972 ·Status: COMPLETED ·Phase: NA
-
An Observational Study Investigating the Positioning of Epidural Catheters and Their Function During Labour Analgesia
NCT02924779 ·Status: UNKNOWN
-
Estimation of Pain During Epidural Analgesia During Labor
NCT02551354 ·Status: COMPLETED ·Phase: NA
-
Effect of Epidural Needle Injection on Catheter Placement Success During Painless Labour
NCT07327918 ·Status: NOT_YET_RECRUITING ·Phase: PHASE3
-
Dural Puncture Epidural VS Standard Epidural on Physician Top-ups During Labour Analgesia
NCT04728048 ·Status: COMPLETED ·Phase: NA
-
Study Comparing Dural Puncture Epidural With Epidural and Combined Spinal Epidural Anesthesia for Obstetric Analgesia.
NCT05196256 ·Status: UNKNOWN ·Phase: PHASE3
-
Pulsatile Pressure Waveform to Confirm Correct Placement of the Epidural in Laboring Patients
NCT02395796 ·Status: TERMINATED ·Phase: NA
-
Comparative Study of the Loading Dose Administrated Via Epidural Needle or Epidural Catheter for Labor Analgesia
NCT05594771 ·Status: COMPLETED ·Phase: NA
-
Intrathecal Hydromorphone for Labor Analgesia
NCT01598506 ·Status: COMPLETED ·Phase: PHASE2
-
Compared Efficacy of Patient-controlled Epidural Analgesia With or Without Automatic Boluses
NCT03407209 ·Status: COMPLETED ·Phase: NA
-
Effect of Epidural Analgesia on Labour, Neonatal and Maternal Outcomes.
NCT05579808 ·Status: COMPLETED
-
Dural Puncture Epidural Versus Combined Spinal Epidural With Epidural Volume Extension in Labor Analgesia
NCT04234178 ·Status: COMPLETED ·Phase: NA
-
Incidence of Pruritus Using Intrathecal Fentanyl Versus Epidural Fentanyl to Initiate Labour Analgesia.
NCT07187427 ·Status: NOT_YET_RECRUITING ·Phase: NA
-
Epidural Loading Prior to Catheter Insertion
NCT02883283 ·Status: WITHDRAWN ·Phase: NA
-
Analgesia in the Second Stage of Labour
NCT04391075 ·Status: COMPLETED
-
Ultrasound-Guided Landmark and Epidural Site Pain
NCT02813681 ·Status: COMPLETED ·Phase: NA
-
DPE Technique in Labor Epidural for Morbidly Obese Women
NCT03074695 ·Status: COMPLETED ·Phase: PHASE4