Ten-year Practice of Labor Pain Control in China

Study Overview
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Brief Summary
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Since 1999, labor pain control has being performed in China, and the initial time of analgesia is at the cervix >= 2 cm. Meanwhile, American Society of Obstetrics & Gynecology recommended that the labor analgesia with neuraxial block should be performed at the cervix >= 4 cm in 2002. After that, the threshold has been revised to at least >= 2 cm in 2006 by the Society. However, in China, the practice of labor analgesia with neuraxial block has being performed for over seven years. Up until now, the practice has being experienced during this ten-year period at the cervix around 1 cm. The investigators hypothesized that labor pain control in different stages had different characteristics and had different influence on patients short- and long-lasting outcomes. This study is mainly investigating different labor analgesia procedures in different stages since the initiation of the practice in 1999, and assessing their influence on the outcomes to display the trajectory of development of labor analgesia in China of which might fit to the the whole process of the study of labor analgesia throughout the world. All these were done by analyzing the data records since from January 1999 to December 2008.

Official Title
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A Ten-year Practice of Labor Pain Control in China

Conditions
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Labor Pain

Intervention / Treatment
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* Procedure: CSEA with PCA
* Procedure: CSEA with IBI
* Procedure: EA with PCA
* Procedure: EA with IBI


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Parturients used labor analgesia Exclusion Criteria: Following criteria were based on the records of information received from the ten-year practice screened by investigators: Chronic pain and psychiatric diseases records Participants younger than 18 years or older than 45 years Alcohol addictive or narcotic dependent patients were excluded for their influence on the analgesic efficacy of the epidural analgesics Subjects with a nonvertex presentation or scheduled induction of labor Diagnosed diabetes mellitus and pregnancy-induced hypertension Twin gestation and breech presentation

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 45 Years

Sexes Eligible for Study
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Female

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| 1<br>Records regarding combined spinal-epidural analgesia (CSEA) with patient-controlled analgesia (PCA) pump | Procedure: CSEA with PCA<br>* Records regarding combined spinal-epidural analgesia with patient-controlled pump<br>|
| 2<br>Records regarding combined spinal-epidural analgesia with intermittent bolus injection (IBI) | Procedure: CSEA with IBI<br>* Records regarding combined spinal-epidural analgesia with intermittent bolus injection<br>|
| 3<br>Records regarding epidural analgesia (EA) with patient-controlled pump | Procedure: EA with PCA<br>* Records regarding epidural analgesia with patient-controlled pump<br>|
| 4<br>Records regarding epidural analgesia with intermittent bolus injection | Procedure: EA with IBI<br>* Records regarding epidural analgesia with intermittent bolus injection<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Rate of cesarean delivery |  | Analgesia initiation to successful vaginal delivery | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Rate of instrument-assisted delivery |  | Analgesia initiation to successful vaginal delivery | 
| Indications of cesarean delivery |  | Analgesia initiation to cesarean section | 
| Maternal Visual Analog Scale (VAS) rating of pain |  | Prior to analgesia, latent phrase, active phrase, second stage of labor, posterior to vaginal delivery | 
| Duration of analgesia |  | Initiation of analgesia to the disappearance of sensory block | 
| Maternal satisfaction with analgesia |  | At the end of the vaginal delivery | 
| Maternal oral temperature |  | Analgesia initiation to successful vaginal delivery | 
| Use of oxytocin after analgesia |  | After analgesia to vaginal delivery | 
| Low back pain at 3 months after vaginal delivery |  | At the third month after vaginal delivery | 
| Breastfeeding success at 6 weeks after vaginal delivery |  | At the sixth week after successful delivery | 
| Neonatal one-minute Apgar scale |  | At the first minute of baby was born | 
| Neonatal five-minute Apgar scale |  | At the fifth minute of baby was born | 
| Incidence of maternal side effects |  | Analgesia initiation to successful vaginal delivery | 
| Umbilical-cord gases analysis |  | At the time baby was born | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Combined spinal-epidural analgesia, Patient-controlled analgesia, Epidural analgesia