40 Participants Needed

EST for Labor Pain

CV
Overseen ByChynna Villanueva, BS, RN
Age: 18+
Sex: Female
Trial Phase: Academic
Sponsor: Stanford University
No Placebo GroupAll trial participants will receive the active study treatment (no placebo)

What You Need to Know Before You Apply

What is the purpose of this trial?

This trial tests a method to reduce labor pain by verifying the placement of an epidural catheter, which delivers pain relief during childbirth. The researchers aim to use an Electrical Epidural Stimulation Test (EST) to ensure the catheter is correctly positioned before and after administering pain medication. This trial is for pregnant women ready to give birth who want an epidural to manage labor pain. Participants should not have allergies to specific pain medications or certain medical conditions, such as neurological disorders.

As an unphased trial, this study allows participants to contribute to research that could enhance epidural procedures for future patients.

Will I have to stop taking my current medications?

The trial requires that you do not use sedatives or opioids, so you would need to stop taking those medications if you are currently using them.

What prior data suggests that this technique is safe for labor pain management?

Research has shown that electrical stimulation methods, such as the Electrical Epidural Stimulation Test (EST), are generally safe. Studies examining the use of electrical stimulation to locate the epidural space during cesarean sections found it to be safe. Additionally, research on similar methods for managing labor pain, like Transcutaneous Electrical Nerve Stimulation (TENS), indicates they are well-tolerated. Although no medical procedure is entirely risk-free, existing studies suggest that EST is a safe option for managing labor pain.12345

Why are researchers excited about this trial?

The Electrical Epidural Stimulation Test (EST) is unique because it offers a novel approach to managing labor pain by using electrical stimulation instead of traditional methods like epidural anesthesia or systemic pain medications. Researchers are excited about this technique because it allows them to measure sensory and motor responses both before and after administering local anesthetics, potentially leading to more personalized pain management strategies. Unlike standard treatments, which mainly focus on blocking pain signals, EST could help optimize anesthetic use and improve overall comfort during labor by providing real-time feedback on the body's response to pain relief interventions.

What evidence suggests that the Electrical Epidural Stimulation Test (EST) is effective for labor pain?

Research has shown that Transcutaneous Electrical Nerve Stimulation (TENS), similar to the Electrical Epidural Stimulation Test (EST) studied in this trial, can reduce labor pain. TENS has proven effective in lowering pain levels for women during labor. In one study, 90% of women using TENS reported satisfaction with the pain relief it provided. Although direct evidence for using EST to manage labor pain is limited, its similarity to TENS suggests potential benefits. Additionally, electrical stimulation has been used to accurately locate epidural spaces, which may support its effectiveness in managing labor pain.46789

Are You a Good Fit for This Trial?

This trial is for women over 18 who are in full-term pregnancy and want epidural pain relief during labor or C-section. They should be generally healthy (ASA I or II). It's not for those with allergies to certain anesthetics, sedative/opioid use, abnormal spine anatomy, neurological issues affecting the lower back, or implanted electronic devices.

Inclusion Criteria

I am in good or mild systemic disease state according to anesthesia standards.
I am a woman aged 18 or older.
You are in the late stages of pregnancy and have asked for an epidural at the start of labor.

Exclusion Criteria

I am currently using sedatives or opioids.
My spine's structure is not normal.
I have a nerve condition affecting my lower back.
See 3 more

Timeline for a Trial Participant

Screening

Participants are screened for eligibility to participate in the trial

1-2 weeks

Treatment

Participants undergo the Electrical Epidural Stimulation Test (EST) to confirm epidural catheter placement before and after anesthetic administration

1-2 hours
1 visit (in-person)

Follow-up

Participants are monitored for pain scores approximately 3 hours after anesthetic introduction

3 hours

What Are the Treatments Tested in This Trial?

Interventions

  • Electrical Epidural Stimulation Test (EST)
Trial Overview The study tests a method called Electrical Epidural Stimulation Test (EST) to confirm correct placement of epidural catheters used for continuous pain relief during childbirth. This technique was developed by the principal investigator about two decades ago.
How Is the Trial Designed?
1Treatment groups
Experimental Treatment
Group I: Electrical Epidural Stimulation Test (EST)Experimental Treatment1 Intervention

Find a Clinic Near You

Who Is Running the Clinical Trial?

Stanford University

Lead Sponsor

Trials
2,527
Recruited
17,430,000+

Published Research Related to This Trial

Transcutaneous electrical nerve stimulation (TENS) showed weak evidence for reducing pain during labor based on a systematic review of eight trials involving 712 women.
While TENS may reduce the likelihood of needing additional pain relief during labor, the overall analgesic effect is not compelling, suggesting that any observed benefits could be due to biases in the studies.
Transcutaneous electrical nerve stimulation in labour pain: a systematic review.Carroll, D., Tramèr, M., McQuay, H., et al.[2019]

Citations

The effects of transcutaneous electrical nerve stimulation ...This study indicates that TENS can be used as a non-pharmacological therapy to reduce pain and shorten the active labor phase.
EST for Labor PainWhile there is no direct evidence for Electrical Epidural Stimulation Test (EST) in labor pain, studies on a similar treatment, Transcutaneous Electrical Nerve ...
Evaluating the effectiveness of TENS for maternal ...TENS was found to be favorable in 90% of parturients as compared to 96.6% in epidural (P 0.301). The number of highly satisfied parturients was ...
a Systematic Review and Meta-Analysis10 studies (90%) demonstrating a statistically significant improvement in pain relief following EA application compared with sham EA, sham manual and EA, and ...
Efficacy of electrical stimulation on epidural anesthesia for ...The purpose of this study was to assess the efficacy and safety of electrical stimulation to identify epidural spaces in cesarean section.
Efficacy of electrical stimulation on epidural anesthesia for ...The purpose of this study was to assess the efficacy and safety of electrical stimulation to identify epidural spaces in cesarean section.
The Response Patterns to the Electrical Stimulation of ...Despite a very high success rate, the epidural technique remains a somewhat blind technique and failures continue to occur.
Electrical Stimulation Test for Labor Pain · Info for ParticipantsResearch on electrical stimulation for labor pain, such as Transcutaneous Electrical Nerve Stimulation (TENS), suggests it is generally safe for use in humans.
A systematic review and network meta-analysisThis systematic review and network meta-analysis were performed to compare different interventions for the reduction of labor pain.
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