Injection Group: Patients will receive \[10 ml of local anesthetic\] through an epidural needle before catheter advancement.
Control group: No injection before catheter insertion.
Study summary
Epidural analgesia is the gold standard for painless labour, but successful catheter placement can be technically challenging due to anatomical and physiological changes in pregnancy. Injecting saline or local anesthetic through the epidural needle before catheter insertion has been proposed to facilitate catheter advancement by dilating the epidural space. This study aimed to evaluate the effect of epidural needle injection on the success rate and ease of catheter placement during labour analgesia.
Eligibility
Sex
FEMALE
Min age
18 Years
Max age
40 Years
Healthy volunteers
No
Inclusion Criteria:
* Female patients aged 18-40 years.
* ASA physical status II or III.
* Singleton pregnancy.
* Gestational age ≥37 weeks.
* Active labour with cervical dilatation ≥3 cm.
* Cephalic presentation.
* Requesting epidural analgesia for painless labour.
* Ability to provide written informed consent.
Exclusion Criteria:
* • Refusal to participate or to sign informed consent.
* Age \<18 or \>40 years.
* ASA status ≥IV.
* Allergy to local anesthetics or saline.
* Coagulopathy or platelet count \<100,000/mm³.
* Local infection at the insertion site.
* Severe spinal deformity (scoliosis, kyphosis).
* Multiple pregnancy.
* Non-cephalic presentation (breech, transverse).
* Antepartum hemorrhage or placenta previa.
* Severe preeclampsia or eclampsia.
* Signs of fetal distress.
* Previous lumbar spine surgery.
* Difficult epidural anatomy (on ultrasound or palpation).
* BMI \>40 kg/m²
Primary outcome measure(s)
Success of epidural catheterization on the first attempt. — Assessed immediately during the procedure at the time of epidural catheter placement. The incidence of success of epidural catheterization on the first attempt will be determined. This measures whether the epidural catheter is successfully inserted on the first attempt after loss of resistance, without the need for repositioning or reattempt. Success is defined by obtaining adequate analgesia with proper catheter function (confirmed by clinical effect).
This page summarises publicly available registry data for informational purposes — not medical advice. Eligibility is determined by each study team; patients should discuss participation with their clinician.
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