Comparison of the effect of bolus epidural injection and continuous epidural infusion of lidocaine 1% on pain, normal delivery and motor function in patients with epidural analgesia

Comparison of bolus injection and continuous epidural infusion of lidocaine 1% on pain, normal delivery and motor function in patients with epidural analgesia

50 patients are entered into a randomized, single-blind, phase 2-3 clinical trial and randomly assigned into 4 blocks and entered into one of the two groups of continuous and bolus epidural analgesia.

After placing catheter in epidural space, eligible patients in the Fatemieh Hospital of Hamedan received 10 ml of lidocaine 1% in epidural space and randomly placed in one of two groups of bolus or continuous and two types of analgesia is given . However, evaluator and patient do not know how to drug inject.

Inclusion criteria : Patients aged 16 to 45; First pregnancy; Failure to receive previous analgesic; Vertex presentation; ASA class 1 and 2 Exclusion criteria: Epidural anesthetic contraindications (coagulation problems, hypovolemia, local infection, high ICP and anemia); ASA class 3 and 4; Poor collaboration in epidural analgesia; Failure to cooperate in answering questionnaire questions

After placing catheter in epidural space, in both groups, 10 ml lidocaine 1% plus 1 ml of sufentanil is injected through the catheter into epidural space by anesthetist. Then, in bolus group, every 1 hour, 10 ml lidocaine 1% is injected regularly and in continuous group, lidocaine 1% is infused through a continuous infusion pump at a rate of 10 ml / h in epidural space until delivery.

Both groups are evaluated for VAS of pain and vital signs every 10 minutes. Also, total dose of lidocaine; nausea and vomiting; delivery progress; level of sensory and motor block and patient's satisfaction with analgesia during delivery is examined by anesthetic nurse and is recorded in questionnaire.

In this study, the randomization method is used as a 4-block block. In this way, according to the sample size, 13 blocks of four are identified, and in each of these four blocks, two of each group will be written in the form of letters A or B. This means that two A and two B are written in each block, although the order of the writing of the four letters A and B will be different in each block. The periodic numbers table will then be used to determine the order of block selection.

After determining the epidural space and placing the catheter in the epidural space, in both groups, the 10 ml lidocaine 1% plus 1 ml of sufentanil is injected through the epidural catheter placed behind the patient. Then, in the bolus group, every one hour, 10 ml lidocaine 1% through an epidural catheter is bolusly injected into the epidural space by anesthesiologist regularly until delivery.In the continuous infusion group, lidocaine 1% is infused through a continuous infusion pump at a rate of 10 ml / h into the epidural space until delivery. The questionnaire is then completed by an anesthetist nurse. In this study, the evaluator and the patient do not know the type of drug administration as bolus and continuous infusion.