The Effects of Different Puncture Points on Labor Analgesia Onset: Study Protocol for a Randomized Controlled Trial

Abstract

Purpose

Parturients suffer severe pain during the stages of labor, especially the first and second. Epidural anesthesia is an effective method to alleviate labor pain. L2-3, L3-4 and L4-5 spaces have been reported to be the recommendable puncture points owing to the adequate analgesia effect and high safety. However, the speed of pain alleviation via the three points has hardly been determined, which is of great importance to parturients. Thus, the aim of this study is to compare the onset time of parturients’ painless uterine contraction after epidural labor analgesia through different puncture points.

Study Design and Methods

It is a prospective, randomized, controlled, and subject- and assessor-blinded study. Totally, 150 subjects scheduled for vaginal delivery are going to be randomly assigned into the L2-3 and L3-4 group. Puncture point in L2-3 group is lumbar 2–3 space, while in L3-4 group it is lumbar 3–4 space. Analgesia initiation and maintenance are the same between the two groups. Primary outcome will be percentage of painless uterine contraction 15 min after epidural labor analgesia initiation. Secondary outcomes will be the sensory blocking level, motor blocking score, adverse effects of parturients, drug liquid consumption in unit interval, apgar score and degree of satisfaction of the parturients.

Discussion

This study estimates the onset time of parturients’ painless uterine contraction after epidural labor analgesia through L2-3 or L3-4 space. The results may provide a better choice to relieve labor pain as soon as possible.

Keywords:

• labor analgesia
• epidural anesthesia
• puncture points
• rapid analgesia

Trial Status

This trial was registered at Chinese Clinical Trial Registry on 16 April, 2023 (identifier ChiCTR2300070548). The study protocol was approved by the Ethics Committee of Deyang People’s Hospital on 06 April, 2023 (reference number 2023-04-026-H01). The first subject was recruited on 16 April, 2023, and the deadline was estimated to be 11 April, 2024.

Acquisition of Data

Six months after the results being published, the data could be acquired from the corresponding author upon reasonable purpose.

Acknowledgments

This study is an investigator-initiated clinical trial of Deyang People’s Hospital. There are no funds supporting us. However, this work is supported by Department of Anesthesiology and Department of Obstetrics in Deyang People’s Hospital.

Disclosure

The authors declare that there are no conflicts of interest for this work.