This trial is evaluating whether Bupivacaine Hydrochloride will improve 1 primary outcome in patients with Labor Pain. Measurement will happen over the course of 30 min.
This trial requires 100 total participants across 2 different treatment groups
This trial involves 2 different treatments. Bupivacaine Hydrochloride is the primary treatment being studied. Participants will all receive the same treatment. There is no placebo group. The treatments being tested are in Phase 4 and have been shown to be safe and effective in humans.
In this pilot study, the use of an epidural for labor pain decreased the duration of labor, but the effect was less than anticipated. Other studies need to be conducted to determine if this effect is permanent.
Labor pain can be classified into two subtypes. Contractions that stop within 1 hour post-delivery are termed postpartum pain and those over 1 hour post-delivery as postpartum pain.
There were no significant differences between the mean VAS scores for the bupivacaine group when compared to the placebo at 2, 4, and 8 h. More importantly, there were no adverse effects in terms of nausea, vomiting, or pain and nausea scores.
About 70,000 women will be in labor, experiencing labor pain, every year in the United States. This figure includes those suffering from spontaneous miscarriage and premature birth. About 33,000 will have severe labor pain requiring admission to a hospital (for example the woman will need medical assistance due to severe back pain or choriocarcinoma).
Women suffering from pain during the labor process are likely suffering from a number of things, including anxiety and discomfort related to the process, preexisting medical diagnoses and the actual birthing process, and a traumatic birth, which could all cause pain related to labor. Doctors, in an effort to keep patients out of hospital and out of pain, often try to treat pain by giving them more epidural blocks; this is the main reason for the current [trend] of 'injecting too much morphine'.
Pain during labour is relatively common and can occur with or without rupture of membranes. It can appear as a dull, dull ache in the lower abdomen that may be constant or worsen over time.
Unfortunately, labor pain can not be fully alleviated by medication, but some pain can be minimized and tolerable by educating women and using techniques including active support and education, massage, relaxation, exercise, and dietary adjustments.
This review concludes that bupivacaine may be of value as a local anesthetic adjuvant in obstetric procedures. The evidence does not allow a conclusive answer regarding its value during labor. Further prospective studies are needed to better assess the safety of bupivacaine in human pregnancies.
It was demonstrated the analgesic effect of bupivacaine after its intrathecal application into the lumbar region. Pain scores at both 1 and 30 minutes of application were lower than analgesic efficacy of the 2% chloroform bupivacaine intrathecal application.
Findings from a recent study show that bupivacaine hydrochloride can reduce pain, particularly when combined with lidocaine, pethidine and cyclobenzaprine but can worsen analgesia when combined with epinephrine or ketamine in the epidural space and in lower concentrations has been proven to cause analgesia in anesthesiology, with or without morphine in the spinal fluid.
There are no new reports of long-term adverse events following peripheral nerve block with bupivacaine hydrochloride for labour analgesia. This is consistent with studies, which demonstrated effectiveness of high doses of bupivacaine for caesarean section.
While no new discoveries in labor pain treatment were reported, the authors did recommend that future investigations should focus on developing new treatments. As new data on the mechanisms of labor pain are emerging, we anticipate the search for new treatments will continue.