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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  
Name  Address 
NIL  NIL 
 
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  
Status 
Not Applicable 
 
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
  1. What data in particular will be shared?
    Response - All of the individual participant data collected during the trial, after de-identification.

  2. What additional supporting information will be shared?
    Response -  Study Protocol
    Response -  Statistical Analysis Plan
    Response - Informed Consent Form
    Response - Clinical Study Report

  3. Who will be able to view these files?
    Response - Anyone

  4. For what types of analyses will this data be available?
    Response - Any purpose.

  5. By what mechanism will data be made available?
    Response - Data are available indefinitely at (Link to be included pritimourya9646@gmail.com).

  6. 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.

  7. 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 epidural”.

 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

 
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