Ropivacaine + Fentanyl for Labor Pain Relief

(EV90_DPE Trial)

AB
Overseen ByAlexander Butwick, MBBS, FRCA, MS
Age: 18+
Sex: Female
Trial Phase: Phase 3
Sponsor: University of California, San Francisco
No Placebo GroupAll trial participants will receive the active study treatment (no placebo)
Pivotal Trial (Near Approval)This treatment is in the last trial phase before FDA approval
Prior Safety DataThis treatment has passed at least one previous human trial

What You Need to Know Before You Apply

What is the purpose of this trial?

This trial aims to determine the optimal dosage of two medications, ropivacaine and fentanyl, for effectively relieving pain during labor. Researchers will assess the effectiveness of these medicines within the first 30 minutes of administering an epidural and will also evaluate any side effects and participant satisfaction with pain relief. The trial is suitable for pregnant individuals in active labor with a single baby, who have a cervical dilation between 2 and 7 cm, and are interested in receiving an epidural for pain relief. As a Phase 3 trial, this study represents the final step before FDA approval, offering participants an opportunity to contribute to advancements in labor pain management.

Will I have to stop taking my current medications?

The trial does not specify if you need to stop taking your current medications, but if you have chronic pain or use opioids regularly, you cannot participate.

Is there any evidence suggesting that this trial's treatments are likely to be safe?

Research has shown that combining ropivacaine and fentanyl for labor pain relief is generally safe and well-tolerated. Studies have found that this combination reduces the risk of motor blocks, making it less likely to cause movement difficulties—a common concern with epidurals. No major differences in side effects were observed when comparing this combination to other similar treatments, suggesting it is a safe option. This combination is already approved for similar pain relief purposes, supporting its safety for use in humans.12345

Why are researchers excited about this trial's treatments?

Researchers are excited about combining ropivacaine and fentanyl for labor pain relief because this approach might offer effective pain management with potentially fewer side effects. Unlike traditional epidurals, which often rely heavily on local anesthetics, this combination could provide strong analgesia with a lower dose of ropivacaine, reducing the risk of motor block. Fentanyl, a potent opioid, works synergistically with ropivacaine to enhance pain relief while allowing mothers to maintain more sensation and mobility during labor. This combination aims to offer a balanced and more comfortable experience for expecting mothers.

What evidence suggests that Ropivacaine and Fentanyl might be effective for labor pain relief?

Studies have shown that a mix of ropivacaine and fentanyl effectively relieves labor pain. This combination offers strong pain relief without excessive muscle weakness. Research indicates it works as well as other common pain relief options but with fewer side effects, such as muscle weakness. This allows patients to receive pain relief while maintaining mobility. Overall, this combination is both effective and safe for managing labor pain.12367

Who Is on the Research Team?

AB

Alexander Butwick, MBBS, FRCA, MS

Principal Investigator

University of California, San Francisco

Are You a Good Fit for This Trial?

This trial is for pregnant individuals seeking pain relief during labor who wish to receive an epidural. Participants must be at a stage of labor where epidural analgesia is appropriate, and they should not have any health conditions that would make receiving an epidural unsafe.

Inclusion Criteria

Cervical dilatation between 2 and 7 cm
Patients with singleton vertex pregnancies in active labor (latent or spontaneous labor or after induction of labor)
Requesting neuraxial labor analgesia
See 1 more

Exclusion Criteria

Multiple gestations
Allergy or anaphylaxis to local anesthetic
I have had serious pregnancy-related issues like pre-eclampsia.
See 5 more

Timeline for a Trial Participant

Screening

Participants are screened for eligibility to participate in the trial

1-2 weeks

Treatment

Participants receive a dural-puncture epidural technique with 0.1% ropivacaine and fentanyl for labor analgesia

Immediate
1 visit (in-person)

Follow-up

Participants are monitored for pain relief effectiveness and side effects 30 minutes post-intervention

30 minutes

What Are the Treatments Tested in This Trial?

Interventions

  • Fentanyl
  • Ropivacaine
Trial Overview The study tests the effectiveness of combining Ropivacaine with Fentanyl in different doses as an initial treatment for labor pain relief via epidural. It aims to find the most effective dose within the first 30 minutes and assess patient satisfaction with pain management.
How Is the Trial Designed?
1Treatment groups
Experimental Treatment
Group I: Observational CohortExperimental Treatment1 Intervention

Find a Clinic Near You

Who Is Running the Clinical Trial?

University of California, San Francisco

Lead Sponsor

Trials
2,636
Recruited
19,080,000+

Citations

Epidural Analgesia With Bupivacaine and Fentanyl Versus...Analgesia with ropivacaine in combination with fentanyl at 0.1%:0.0002% ratio for labor pain relief is associated with lower incidence of motor blocks.
Epidural Analgesia With Bupivacaine and Fentanyl Versus ...Analgesia with ropivacaine in combination with fentanyl at 0.1%:0.0002% ratio for labor pain relief is associated with lower incidence of motor blocks.
A review article on epidural analgesia for labor pain ...A meta-analysis conducted by Li et al. showed that, combined with fentanyl, bupivacaine and ropivacaine exhibited comparable efficacy and safety. It also added ...
Epidural Infusions for Labor Analgesia: A Comparison ...We conclude that epidural infusion of 0.1% ropivacaine alone at 10 mL/h provided adequate analgesia in the first stage of labor.
The impact of epidural ropivacaine versus levobupivacaine for ...To conclude, our analysis showed both epidural ropivacaine and levobupivacaine to be equally effective for labor analgesia in terms of maternal ...
Technical aspects of neuraxial analgesia during labor and ...It consists of lowering the pain associated with childbirth labor by improving maternal–fetal clinical outcomes as well as the maternal pain ...
Comparison of Ropivacaine-Fentanyl with Bupivacaine- ...No significant difference in the side effects between the two groups. Hence, Ropivacaine can be used as a safe alternative to bupivacaine for ...
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