对比腰硬联合麻醉与连续硬膜外麻醉在顺产经产妇分娩镇痛中的效果观察

注册号:

Registration number:

ChiCTR2500102703 

最近更新日期:

Date of Last Refreshed on:

2025-05-19 11:13:09 

注册时间:

Date of Registration:

2025-05-19 00:00:00 

注册号状态:

预注册

Registration Status:

Prospective registration

注册题目:

对比腰硬联合麻醉与连续硬膜外麻醉在顺产经产妇分娩镇痛中的效果观察

Public title:

Comparison of the effects of lumbar epidural anesthesia and continuous epidural anesthesia on pain relief during vaginal delivery in multiparous women

注册题目简写:

English Acronym:

研究课题的正式科学名称:

对比腰硬联合麻醉与连续硬膜外麻醉在顺产经产妇分娩镇痛中的效果观察

Scientific title:

Comparison of the effects of lumbar epidural anesthesia and continuous epidural anesthesia on pain relief during vaginal delivery in multiparous women

研究课题代号(代码):

Study subject ID:

在二级注册机构或其它机构的注册号:

The registration number of the Partner Registry or other register:

申请注册联系人:

罗丽丽 

研究负责人:

罗丽丽 

Applicant:

Luo Lili 

Study leader:

Luo Lili 

申请注册联系人电话:

Applicant telephone:

+86 183 7096 0197

研究负责人电话:

Study leader's
telephone:

+86 139 7093 6268

申请注册联系人传真 :

Applicant Fax:

研究负责人传真:

Study leader's fax:

申请注册联系人电子邮件:

Applicant E-mail:

645560017@qq.com

研究负责人电子邮件:

Study leader's E-mail:

zqwxj@163.com

申请单位网址(自愿提供):

Applicant website(voluntary supply):

研究负责人网址(自愿提供):

Study leader's website(voluntary supply):

申请注册联系人通讯地址:

江西省南昌市八一大道318号

研究负责人通讯地址:

江西省南昌市八一大道318号

Applicant address:

No. 318 Bayi Avenue, Nanchang City, Jiangxi Province

Study leader's address:

No. 318 Bayi Avenue, Nanchang City, Jiangxi Province

申请注册联系人邮政编码:

Applicant postcode:

330000

研究负责人邮政编码:

Study leader's postcode:

330000

申请人所在单位:

江西省妇幼保健院

Applicant's institution:

Jiangxi Maternal and Child Health Hospital

研究负责人所在单位:

江西省妇幼保健院

Affiliation of the Leader:

Jiangxi Maternal and Child Health Hospital

是否获伦理委员会批准:

Approved by ethic committee:

Yes

伦理委员会批件文号:

Approved No. of ethic committee:

EC-KY-2025031

伦理委员会批件附件:

Approved file of Ethical Committee:

查看附件View

批准本研究的伦理委员会名称:

江西省妇幼保健院医学伦理委员会

Name of the ethic committee:

Medical Ethics Committee of Jiangxi Maternal and Child Health Hospital

伦理委员会批准日期:

Date of approved by ethic committee:

2025-03-05 00:00:00

伦理委员会联系人:

李方元

Contact Name of the ethic committee:

Li Fangyuan

伦理委员会联系地址:

江西省南昌市八一大道318号

Contact Address of the ethic committee:

No. 318 Bayi Avenue, Nanchang City, Jiangxi Province

伦理委员会联系人电话:

Contact phone of the ethic committee:

+86 82725185

伦理委员会联系人邮箱:

Contact email of the ethic committee:

研究实施负责(组长)单位:

江西省妇幼保健院

Primary sponsor:

Jiangxi Maternal and Child Health Hospital

研究实施负责(组长)单位地址:

江西省南昌市八一大道318号

Primary sponsor's address:

No. 318 Bayi Avenue, Nanchang City, Jiangxi Province

试验主办单位(项目批准或申办者):

Secondary sponsor:

国家:

中国

省(直辖市):

江西省

市(区县):

南昌市

Country:

China

Province:

Jiangxi Province

City:

Nanchang city

单位(医院):

江西省妇幼保健院

具体地址:

江西省南昌市八一大道318号

Institution
hospital:

Jiangxi Maternal and Child Health Hospital

Address:

No. 318 Bayi Avenue, Nanchang City, Jiangxi Province

经费或物资来源:

自费

Source(s) of funding:

Self funded

研究疾病:

无痛分娩  

Target disease:

Painless childbirth

研究疾病代码:

Target disease code:

研究类型:

干预性研究

Study type:

Interventional study

研究所处阶段:

其它 

Study phase:

N/A

研究设计:

随机平行对照 

Study design:

Parallel 

研究目的:

本研究旨在通过对比腰硬联合麻醉与连续硬膜外麻醉在顺产经产妇分娩镇痛中的效果观察,为产妇提供安全舒适的分娩镇痛体验,提高产妇满意度。  

Objectives of Study:

The aim of this study is to compare the effects of lumbar epidural anesthesia and continuous epidural anesthesia on pain relief during vaginal delivery in multiparous women, in order to provide a safe and comfortable pain relief experience and improve maternal satisfaction.

药物成份或治疗方案详述:

确定您可以参加本研究后,签署分娩镇痛知情同意书,完善血常规,凝血功能检查。再进行随机分组,分为对照组和观察组,对照组应用硬膜外麻醉分娩镇痛:选择L2~3或L3~4间隙,严格按照椎管内穿刺操作规范进行硬膜外穿刺,向头端置入硬膜外导管3~4 cm。排除硬膜外置入血管或蛛网膜下腔后,注入首剂量。本院首剂量为0.1%的罗哌卡因(国药准字H20163208;规格:10mL:75mg)+舒芬太尼(国药准字H20054171;规格:1mL:50μg)0.33μg/mL共10ml生理氯化钠溶液。首剂量后,接患者硬膜外自控镇痛泵(patient controlled epidural analgesia,PCEA),维持剂量为0.1%的罗哌卡因和0.33μg/mL的舒芬太尼共140 mL生理氯化钠溶液,镇痛泵设置8~10 mL/h,追加量8 mL生理氯化钠溶液,锁定时间15~30 min。根据产妇疼痛情况个性化给药,在宫口开全以后,若产妇感觉到腿部麻木,停止使用镇痛泵;若产妇无腿部麻木,则继续使用。 观察组应用腰硬联合麻醉:选择L2~3或L3~4间隙,穿刺成功后,取细长空芯腰针(25G)刺入蛛网膜下腔,取0.1%罗哌卡因2.5 mg缓慢向头端注入,硬膜外腔置管,30 min后与硬膜外自控镇痛泵连接,剂量同对照组维持量,即0.1%的罗哌卡因和0.33μg/mL的舒芬太尼共150 mL生理氯化钠溶液,镇痛泵设置8 mL/h,追加量8 mL,锁定时间15~30 min。 麻醉前进行血压和心率监测,左手置一根外周静脉通道。麻醉前由麻醉护士对产妇进行疼痛评分采用VAS评分量表,记录麻醉前,麻醉后5min,10min,30min,60minVAS评分。 

Description for medicine or protocol of treatment in detail:

After confirming that you can participate in this study, sign the informed consent form for labor analgesia, complete blood routine and coagulation function tests. Random grouping will be conducted again, divided into a control group and an observation group. The control group will receive epidural anesthesia for labor analgesia: select the L2-3 or L3-4 interval, strictly follow the spinal canal puncture operation specifications for epidural puncture, and insert an epidural catheter 3-4 cm into the head end. After excluding external dura mater insertion into blood vessels or subarachnoid space, inject the first dose. The first dose of our hospital is a 10ml physiological sodium chloride solution consisting of 0.1% ropivacaine (National Medical Standard H20163208; specification: 10mL: 75mg) and sufentanil (National Medical Standard H20054171; specification: 1mL: 50 μ g) at a concentration of 0.33 μ g/mL. After the first dose, connect the patient controlled epidural analgesia (PCEA) pump to maintain a dose of 0.1% ropivacaine and 0.33 μ g/mL sufentanil in a total of 140 mL of physiological sodium chloride solution. Set the analgesia pump to 8-10 mL/h and add an additional 8 mL of physiological sodium chloride solution for 15-30 minutes. Individualized medication should be administered according to the pain situation of the parturient. After the cervix is fully opened, if the parturient feels numbness in the legs, stop using the pain pump; If the mother has no numbness in the legs, continue using it. Observation group applied spinal epidural anesthesia: Select the L2-3 or L3-4 interval. After successful puncture, take a thin hollow core lumbar needle (25G) and insert it into the subarachnoid space. Take 2.5 mg of 0.1% ropivacaine and slowly inject it into the head end. Place a tube in the epidural space and connect it to the epidural patient-controlled analgesia pump after 30 minutes. The dosage is the same as the maintenance dose of the control group, which is 150 mL of physiological sodium chloride solution of 0.1% ropivacaine and 0.33 μ g/mL sufentanil. The analgesia pump is set at 8 mL/h, with an additional amount of 8 mL and a locking time of 15-30 min. Monitor blood pressure and heart rate before anesthesia, and place a peripheral venous channel in the left hand. Before anesthesia, the anesthesia nurse evaluates the pain of the parturient using a VAS scoring scale, recording the VAS scores before anesthesia and at 5, 10, 30, and 60 minutes after anesthesia. 

纳入标准:

Inclusion criteria

排除标准:

血小板小于8万者,妊娠合并症,依从性差,药物过敏,先兆子痫前期或在前4小时内给予阿片类药物

Exclusion criteria:

Patients with platelet count less than 80000, pregnancy complications, poor compliance, drug allergies, pre eclampsia, or opioid medication given within the first 4 hours

研究实施时间:

Study execute time:

From 2025-05-01 00:00:00 To 2026-06-30 00:00:00  

征募观察对象时间:

Recruiting time:

From 2025-06-01 00:00:00 To 2026-06-30 00:00:00

干预措施:

Interventions:

组别:

对照组

样本量:

50

Group:

Control group

Sample size:

干预措施:

硬膜外麻醉

干预措施代码:

Intervention:

Epidural anesthesia

Intervention code:

组别:

观察组

样本量:

50

Group:

Observers group

Sample size:

干预措施:

腰硬联合麻醉

干预措施代码:

Intervention:

Combined spinal-epidural anesthesia

Intervention code:

研究实施地点:

Countries of recruitment and research settings:

国家:

中国

省(直辖市):

江西省 

市(区县):

南昌市 

Country:

China

Province:

Jiangxi Province

City:

Nanchang city

单位(医院):

江西省妇幼保健院 

单位级别:

三甲 

Institution
hospital:

Jiangxi Maternal and Child Health Hospital

Level of the institution:

Trimethylamine

测量指标:

Outcomes:

指标中文名:

疼痛VAS评分

指标类型:

主要指标

Outcome:

Pain VAS score

Type:

Primary indicator

测量时间点:

麻醉前及麻醉后5min,10min,30min,60min

测量方法:

填写评分量表

Measure time point of outcome:

Before anesthesia and at 5, 10, 30, and 60 minutes after anesthesia

Measure method:

Fill out the rating scale

指标中文名:

镇痛药物用量

指标类型:

次要指标

Outcome:

Analgesic medication dosage

Type:

Secondary indicator

测量时间点:

手术结束后

测量方法:

查麻醉记录单

Measure time point of outcome:

After the surgery

Measure method:

Check the anesthesia record sheet

指标中文名:

新生儿Apgar评分

指标类型:

次要指标

Outcome:

Neonatal Apgar score

Type:

Secondary indicator

测量时间点:

新生儿出生1分钟及5分钟

测量方法:

查新生儿出生记录单

Measure time point of outcome:

Newborn born at 1 minute and 5 minutes

Measure method:

Check the newborn birth record sheet

指标中文名:

恶心呕吐

指标类型:

次要指标

Outcome:

Nausea and vomiting

Type:

Secondary indicator

测量时间点:

围术期

测量方法:

观察法

Measure time point of outcome:

Perioperative period

Measure method:

Observation method

指标中文名:

产时发热

指标类型:

次要指标

Outcome:

Fever during childbirth

Type:

Secondary indicator

测量时间点:

围术期

测量方法:

观察法

Measure time point of outcome:

Perioperative period

Measure method:

Observation method

指标中文名:

皮肤瘙痒

指标类型:

次要指标

Outcome:

Pruritus

Type:

Secondary indicator

测量时间点:

围术期

测量方法:

观察法

Measure time point of outcome:

Perioperative period

Measure method:

Observation method

采集人体标本:

Collecting sample(s)
from participants:

标本中文名:

组织:

Sample Name:

None

Tissue:

人体标本去向

其它  

说明

Fate of sample:

0thers  

Note:

征募研究对象情况:

Recruiting status:

尚未开始

Not yet recruiting

年龄范围:

Participant age:

最小 Min age years
最大 Max age years

性别:

女性

Gender:

Female

随机方法(请说明由何人用什么方法产生随机序列):

随机分组法 由专人使用Excel软件随机数字表法计算得出

Randomization Procedure (please state who generates the random number sequence and by what method):

Random grouping method Calculated by a dedicated person using the random number table method in Excel software.

是否公开试验完成后的统计结果:

Calculated Results after the Study Completed public access:

不公开/Private

盲法:

试验设置单盲即为试验组与观察组实施麻醉方法对孕产妇设盲

Blinding:

Single blind experimental setup refers to the implementation of anesthesia methods between the experimental group and the observation group to blind pregnant women.

是否共享原始数据:

IPD sharing

否No

共享原始数据的方式(说明:请填入公开原始数据日期和方式,如采用网络平台,需填该网络平台名称和网址):

The way of sharing IPD”(include metadata and protocol, If use web-based public database, please provide the url):

None

数据采集和管理(说明:数据采集和管理由两部分组成,一为病例记录表(Case Record Form, CRF),二为电子采集和管理系统(Electronic Data Capture, EDC),如ResMan即为一种基于互联网的EDC:

数据采集通过纸质版数据收集表,之后录入EXCEL软件 数据管理通过EXCEL, Rstudio, SAS软件

Data collection and Management (A standard data collection and management system include a CRF and an electronic data capture:

Data collection is done through a paper-based data collection form, which is then entered into EXCEL software; Data management is achieved through EXCEL, Rstudio, and SAS software.

数据与安全监察委员会:

Data and Safety Monitoring Committee:

暂未确定/Not yet

注册人:

Name of Registration:

 2025-05-19 11:12:53