Influence of Maternal Postioning on Spread of Local Anesthetic After Epidural Analgesia

Study Overview
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Brief Summary
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The purpose of this study is to determine if a lateral positioning of the pregnant woman after epidural analgesia increases the incidence of unilateral functioning epidurals.

Detailed Description
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Pregnant women requesting epidural analgesia will be randomized to either left lateral or semi-recumbent position for 30 minutes after the first epidural bolus-injection. After 30 minutes, the clinical effect of the analgesia will be evaluated by an anesthesiologist if available or by a midwife if the anesthesiologist is unavailable. The study-period is concluded thereafter and further positioning is optional. Maternal and fetal wellbeing are continuously being monitored during the study period and complications/interventions registered. APGAR and CTG results during the intervention will be registered and evaluated at a later stage.

Official Title
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Influence of Maternal Postioning on Spread of Local Anesthetic After Epidural Analgesia

Conditions
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Effects of; Anesthesia, Spinal and Epidural, in Pregnancy

Intervention / Treatment
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* Procedure: lateral position


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: all adult pregnant women recieiving epidural analgesia Exclusion Criteria: participation refused inability to understand study purpose/instructions study postition could not be maintained for 30 min ineffective epidural

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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Female

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Single


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| No Intervention: semi-recumbent<br>rutine positioning at the hospital today | |
| Experimental: lateral position<br>experimental position to be evaluated against rutine | Procedure: lateral position<br>* patients placed on their left side after epidural catheter insertion<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| unilateral analgesic effect | clinical judgement: mothers pain-sensation and cold sensation test | evaluation of epidural effect after 30 min | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| maternal comfort and safety in regards to blood pressure and/or unexpected neurological effects from epidural analgesia | clinical judgement: mothers subjective wellbeing, bloodpressure and incidence of vena cava compression, neurological deficits from epidural | evaluation of epidural effect after 30 min | 
| fetal/neonatal safety measured with CTG and APGAR score | cardiotocographic changes and APGAR-score evaluation | CTG from start of study until birth, APGAR 2, 5 and 10min after birth |