| CTRI Number |
CTRI/2024/07/070837 [Registered on: 18/07/2024] Trial Registered Prospectively |
| Last Modified On: |
12/07/2024 |
| Post Graduate Thesis |
Yes |
| Type of Trial |
Interventional |
|
Type of Study
|
Drug Surgical/Anesthesia Process of Care Changes Other (Specify) [Obstetric & Gynecology] |
| Study Design |
Randomized, Parallel Group Trial |
|
Public Title of Study
|
The trial assesses the efficacy of continuous epidural infusion of ropivacaine 0.125% and 0.2% mixed with fentanyl for prenatal patients undergoing active labour pain management. |
|
Scientific Title of Study
|
Randomized Controlled Trail Comparing Ropivacaine 0.125% and Ropivacaine 0.2% in Conjunction With Fentanyl For Continuous Epidural Infusion In Antenatal Patients Experiencing Active Labor: An Assessment of Labor Pain Management. |
| Trial Acronym |
NIL |
|
Secondary IDs if Any
|
| Secondary ID |
Identifier |
| NIL |
NIL |
|
|
Details of Principal Investigator or overall Trial Coordinator (multi-center study)
|
| Name |
Priti Mourya |
| Designation |
Junior Resident |
| Affiliation |
All India Institute of Medical Sciences, Nagpur |
| Address |
First floor, OT complex, IPD Building, Department of Anesthesiology & Critical care, All India Institute of Medical Sciences Nagpur, Mihan, Dahegaon , Nagpur , Maharashtra ,441108, India.
Nagpur MAHARASHTRA 441108 India |
| Phone |
8261855197 |
| Fax |
|
| Email |
pritimourya9646@gmail.com |
|
Details of Contact Person Scientific Query
|
| Name |
Dr Avinash Prakash |
| Designation |
Assosciate Professor |
| Affiliation |
All India Institute of Medical Sciences, Nagpur |
| Address |
First floor, OT complex, IPD Building, Department of Anesthesiology & Critical care, All India Institute of Medical Sciences Nagpur, Mihan, Dahegaon , Nagpur , Maharashtra ,441108, India.
Nagpur MAHARASHTRA 441108 India |
| Phone |
9999596845 |
| Fax |
|
| Email |
dravinash@aiimsnagpur.edu.in |
|
Details of Contact Person Public Query
|
| Name |
Dr Avinash Prakash |
| Designation |
Assosciate Professor |
| Affiliation |
All India Institute of Medical Sciences, Nagpur |
| Address |
First floor, OT complex, IPD Building, Department of Anesthesiology & Critical care, All India Institute of Medical Sciences Nagpur, Mihan, Dahegaon , Nagpur , Maharashtra ,441108, India.
Nagpur MAHARASHTRA 441108 India |
| Phone |
9999596845 |
| Fax |
|
| Email |
dravinash@aiimsnagpur.edu.in |
|
|
Source of Monetary or Material Support
|
| All India Institute of Medical Sciences Nagpur, Mihan, Dahegaon , Nagpur , Maharashtra ,441108, India. |
|
|
Primary Sponsor
|
| Name |
Priti Mourya |
| Address |
First floor, OT complex, IPD Building, Department of Anesthesiology & Critical care, All India Institute of Medical Sciences Nagpur, Mihan, Dahegaon , Nagpur , Maharashtra ,441108, India. |
| Type of Sponsor |
Other [Self] |
|
|
Details of Secondary Sponsor
|
|
|
Countries of Recruitment
|
India |
|
Sites of Study
|
| No of Sites = 1 |
| Name of Principal
Investigator |
Name of Site |
Site Address |
Phone/Fax/Email |
| Dr Priti Mourya |
All India Institute of Medical Sciences, Dahegaon,Nagpur,Maharashtra,India-441108 |
First floor, OT complex, IPD Building, Department of Anesthesiology & Critical care, All India Institute of Medical Sciences Nagpur, Mihan, Dahegaon , Nagpur , Maharashtra ,441108, India. Nagpur MAHARASHTRA |
8261855197
pritimourya9646@gmail.com |
|
|
Details of Ethics Committee
|
| No of Ethics Committees= 1 |
| Name of Committee |
Approval Status |
| Institutional Ethics Committee |
Approved |
|
|
Regulatory Clearance Status from DCGI
|
|
|
Health Condition / Problems Studied
|
| Health Type |
Condition |
| Healthy Human Volunteers |
Pregnancy
|
| Patients |
, |
|
|
Intervention / Comparator Agent
|
| Type |
Name |
Details |
| Intervention |
Adequate analgesia |
GROUP A: This group will receive the 12 ml (7)of Ropivacaine 0.125% with 2μg/ml fentanyl via continuous epidural infusion till delivery. |
| Comparator Agent |
Adequate Analgesia with less of sensory and motor block |
GROUP B: This group will receive 12 ml of Ropivacaine 0.2% with 2 μg/ml fentanyl via continuous epidural infusion till delivery. |
|
|
Inclusion Criteria
|
| Age From |
19.00 Year(s) |
| Age To |
35.00 Year(s) |
| Gender |
Female |
| Details |
1. Singleton pregnancy at term (≥37 weeks of
gestation) with vertex presentation.
2. Maternal age should be between 19 and 35 years.
Because according to child marriage act the age
of marriage for girls is 18 years and age ≥35
years is very advanced maternal age with
complicated outcomes like stillbirth, preterm
birth, perinatal death, GDM, gestational
hypertension and preeclampsia.
3. Informed consent provided by the participant.
4. Desire for epidural analgesia for pain
management.
5. Ability to understand and comply with the study
procedures.
|
|
| ExclusionCriteria |
| Details |
1. Refusal to provide informed consent.
2. Twin pregnancy.
3. Breech presentation.
4. Pregnancy with antepartum haemorrhage.
5. History of adverse reactions to local
anaesthetics or opioids.
6.Medical contraindications to epidural
analgesia like increased intracranial pressure,
local infection at the site of puncture,
haemorrhagic diathesis or
therapeutic anticoagulants.
8. Known foetal anomalies or distress
necessitating
immediate delivery.
9. History of drug abuse.
10. Bleeding disorders.
11. Decreased platelet counts.
12. Spinal column deformities.
13. History of spine surgery.
|
|
|
Method of Generating Random Sequence
|
Stratified block randomization |
|
Method of Concealment
|
On-site computer system |
|
Blinding/Masking
|
Participant, Investigator and Outcome Assessor Blinded |
|
Primary Outcome
|
| Outcome |
TimePoints |
| Pain Relief Efficacy: The primary outcome will assess the effectiveness of the analgesic regimens by comparing the degree of pain relief achieved by labouring mothers in Group A (Ropivacaine 0.125% with Fentanyl) and Group B (Ropivacaine 0.2% with Fentanyl). Pain relief will be evaluated using a visual analogue scale (VAS) or other standardized pain assessment tools. |
24 months |
|
|
Secondary Outcome
|
| Outcome |
TimePoints |
1. Analgesic Consumption: The total amount of analgesic agents used by participants in each group will be recorded, including the volume of ropivacaine and the amount of fentanyl administered.
2. Onset and Duration of Pain Relief: The time taken for pain relief to begin (onset) and the duration of effective pain relief for each analgesic regimen will be documented.
3. Safety and Adverse Events: Adverse events associated with each analgesic regimen, such as hypotension, respiratory depression, or other complications, will be monitored and recorded.
4. Neonatal Outcomes: The study will assess the impact of the analgesic regimens on neonatal outcomes, including Apgar scores and any immediate interventions required.
5. Obstetric Outcomes: The effect of pain management choices on obstetric parameters will be analysed. This includes assessing progression, mode of delivery, and any interventions required during.
|
24 months |
|
|
Target Sample Size
|
Total Sample Size="32" Sample Size from India="32"
Final Enrollment numbers achieved (Total)= "Applicable only for Completed/Terminated trials"
Final Enrollment numbers achieved (India)="Applicable only for Completed/Terminated trials" |
|
Phase of Trial
|
Phase 2/ Phase 3 |
|
Date of First Enrollment (India)
|
26/07/2024 |
| Date of Study Completion (India) |
Applicable only for Completed/Terminated trials |
| Date of First Enrollment (Global) |
Date Missing |
| Date of Study Completion (Global) |
Applicable only for Completed/Terminated trials |
|
Estimated Duration of Trial
|
Years="2" Months="0" Days="0" |
|
Recruitment Status of Trial (Global)
|
Not Applicable |
| Recruitment Status of Trial (India) |
Not Yet Recruiting |
|
Publication Details
|
N/A |
|
Individual Participant Data (IPD) Sharing Statement
|
Will individual participant data (IPD) be shared publicly (including data dictionaries)?
Response - YES
- What data in particular will be shared?
Response - All of the individual participant data collected during the trial, after de-identification.
- What additional supporting information will be shared?
Response - Study Protocol Response - Statistical Analysis Plan Response - Informed Consent Form Response - Clinical Study Report
- Who will be able to view these files?
Response - Anyone
- For what types of analyses will this data be available?
Response - Any purpose.
- By what mechanism will data be made available?
Response - Data are available indefinitely at (Link to be included pritimourya9646@gmail.com).
- For how long will this data be available start date provided 01-03-2026 and end date provided 01-03-2036?
Response - Immediately following publication. No end date.
- Any URL or additional information regarding plan/policy for sharing IPD?
Additional Information - NIL
|
|
Brief Summary
|
Labour
pain is one of the most painful experience for a woman. Evidence is suggestive
that disorders including maternal hypertension, dystocia, meconium staining,
and foetal distress are stress related.
Of
all the available methods of analgesia, epidural analgesia satisfies the basic
requirements of analgesia by fulfilling the objective of decreasing the pains
without affecting other sensations such as a desire to push and to allow normal
walking while preserving the tone of pelvic floor muscles. This EA technique
has been commonly named as “walking epiduralâ€.
Ropivacaine, a well-established local
anaesthetic agent, has gained recognition for its favourable safety profile,
particularly in comparison to its counterpart, bupivacaine. Its use in epidural
analgesia, either as a standalone agent or in combination with adjuvants like
fentanyl, has become a standard practice in obstetric anaesthesia.
There
are only few studies comparing between 0.125% ropivacaine and 0.2% ropivacaine
for labour pain management. We hypothesise that 0.125% ropivacaine is equally
effective analgesic as 0.2% ropivacaine for labour pain with less of motor
block and other associated side effects. This study will be conducted over a
period of 18 months after the approval of Institutional Ethics Committee, with
calculated sample size of 32 in total. With due inclusion and exclusion
criteria set. Patients will be divided in two groups by computer generated
double blinded block randomization technique.
GROUP A: This group will receive the 12 ml (7)of Ropivacaine 0.125% with 2μg/ml fentanyl. GROUP B: This group will receive 12 ml
of Ropivacaine 0.2% with 2 μg/ml fentanyl.
Pain scores (VAS), sensory and motor block
characteristics, and vital parameters (pulse, mean arterial pressure,
respiratory rate) will be documented at 0 (before epidural), 5, 15 minutes, and
then every 10 minutes until 1 hour, followed by assessments every 60 minutes
until delivery. Throughout the study, fetal heart rate will be continuously
monitored using a cardiotocograph (CTG). Further assessment will include
evaluating the Apgar score at 1 and 5 minutes.
This
study informs personalized pain management, enhances safety and maternal
satisfaction, and influences healthcare policy. It advances evidence-based
obstetric anaesthesia practices, contributing to a more patient-centered approach in, potentially improving the childbirth experience for mothers, and
informing future research and clinical guidelines |