Yibing Yu, Qingsong Zhao, Yu Zang, Zhiqiang Liu, Weijia Du
{"title":"硬膜外导管设计对程序性间歇硬膜外注射镇痛效果的影响：一项随机双盲对照试验。","authors":"Yibing Yu, Qingsong Zhao, Yu Zang, Zhiqiang Liu, Weijia Du","doi":"10.2147/DDDT.S545076","DOIUrl":null,"url":null,"abstract":"<p><strong>Purpose: </strong>To compare analgesic outcomes between single- and multi-orifice epidural catheters at a 360-mL/h delivery rate during programmed intermittent epidural bolus.</p><p><strong>Patients and methods: </strong>In this prospective randomized double-blinded controlled trial, 102 healthy nulliparous parturients requesting labor analgesia at the Shanghai First Maternity and Infant Hospital were enrolled from July to September 2023. Participants were given either single- or multi-orifice catheters for epidural analgesia (0.1% ropivacaine with 0.3 µg/mL of sufentanil; 10 mL every 45 min at 360 mL/h). The primary outcome was ropivacaine consumption per hour, calculated as the total amount of ropivacaine administered divided by the duration of labor analgesia (mg/h).</p><p><strong>Results: </strong>Median ropivacaine consumption per hour was not significantly different: 12.6 mg/h [11.6-13.2 mg/h] for single-orifice vs 12.8 mg/h [12.3-13.3 mg/h] for multi-orifice catheters (difference 29%; 95% confidence interval [CI], -10.2 to 68.2%; <i>P</i>=0.241). No significant differences were found in patient-controlled epidural analgesia boluses requested and delivered, time to first bolus request, or the number of clinician-administered boluses. However, adequate analgesia at 20 min was higher with single-orifice catheters (84.0% vs 63.5%, difference 22.5%; 95% CI: 9.2% to 35.1%, <i>P</i>=0.019). Median times to adequate analgesia were 8 min [4-16] vs 15 min [9.5-22.5] for single- and multi-orifice catheters (<i>P</i>=0.002). Pain scores differed only at 6 and 18 min. There were no differences in the incidence of motor or unilateral block, side effects, maternal satisfaction, or catheter-related complications between the two groups.</p><p><strong>Conclusion: </strong>Single-orifice catheters did not enhance analgesia quality during labor maintenance under a 360-mL/h programmed intermittent epidural bolus delivery rate but were linked to more rapid analgesic onset than multi-orifice catheters.</p>","PeriodicalId":11290,"journal":{"name":"Drug Design, Development and Therapy","volume":"19 ","pages":"7581-7590"},"PeriodicalIF":5.1000,"publicationDate":"2025-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12413817/pdf/","citationCount":"0","resultStr":"{\"title\":\"Effect of Epidural Catheter Design on Analgesic Efficacy During Programmed Intermittent Epidural Boluses: A Randomized Double-Blinded Controlled Trial.\",\"authors\":\"Yibing Yu, Qingsong Zhao, Yu Zang, Zhiqiang Liu, Weijia Du\",\"doi\":\"10.2147/DDDT.S545076\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Purpose: </strong>To compare analgesic outcomes between single- and multi-orifice epidural catheters at a 360-mL/h delivery rate during programmed intermittent epidural bolus.</p><p><strong>Patients and methods: </strong>In this prospective randomized double-blinded controlled trial, 102 healthy nulliparous parturients requesting labor analgesia at the Shanghai First Maternity and Infant Hospital were enrolled from July to September 2023. Participants were given either single- or multi-orifice catheters for epidural analgesia (0.1% ropivacaine with 0.3 µg/mL of sufentanil; 10 mL every 45 min at 360 mL/h). The primary outcome was ropivacaine consumption per hour, calculated as the total amount of ropivacaine administered divided by the duration of labor analgesia (mg/h).</p><p><strong>Results: </strong>Median ropivacaine consumption per hour was not significantly different: 12.6 mg/h [11.6-13.2 mg/h] for single-orifice vs 12.8 mg/h [12.3-13.3 mg/h] for multi-orifice catheters (difference 29%; 95% confidence interval [CI], -10.2 to 68.2%; <i>P</i>=0.241). No significant differences were found in patient-controlled epidural analgesia boluses requested and delivered, time to first bolus request, or the number of clinician-administered boluses. However, adequate analgesia at 20 min was higher with single-orifice catheters (84.0% vs 63.5%, difference 22.5%; 95% CI: 9.2% to 35.1%, <i>P</i>=0.019). Median times to adequate analgesia were 8 min [4-16] vs 15 min [9.5-22.5] for single- and multi-orifice catheters (<i>P</i>=0.002). Pain scores differed only at 6 and 18 min. There were no differences in the incidence of motor or unilateral block, side effects, maternal satisfaction, or catheter-related complications between the two groups.</p><p><strong>Conclusion: </strong>Single-orifice catheters did not enhance analgesia quality during labor maintenance under a 360-mL/h programmed intermittent epidural bolus delivery rate but were linked to more rapid analgesic onset than multi-orifice catheters.</p>\",\"PeriodicalId\":11290,\"journal\":{\"name\":\"Drug Design, Development and Therapy\",\"volume\":\"19 \",\"pages\":\"7581-7590\"},\"PeriodicalIF\":5.1000,\"publicationDate\":\"2025-09-02\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12413817/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Drug Design, Development and Therapy\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.2147/DDDT.S545076\",\"RegionNum\":2,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2025/1/1 0:00:00\",\"PubModel\":\"eCollection\",\"JCR\":\"Q1\",\"JCRName\":\"CHEMISTRY, MEDICINAL\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Drug Design, Development and Therapy","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.2147/DDDT.S545076","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/1/1 0:00:00","PubModel":"eCollection","JCR":"Q1","JCRName":"CHEMISTRY, MEDICINAL","Score":null,"Total":0}
Effect of Epidural Catheter Design on Analgesic Efficacy During Programmed Intermittent Epidural Boluses: A Randomized Double-Blinded Controlled Trial.
Purpose: To compare analgesic outcomes between single- and multi-orifice epidural catheters at a 360-mL/h delivery rate during programmed intermittent epidural bolus.
Patients and methods: In this prospective randomized double-blinded controlled trial, 102 healthy nulliparous parturients requesting labor analgesia at the Shanghai First Maternity and Infant Hospital were enrolled from July to September 2023. Participants were given either single- or multi-orifice catheters for epidural analgesia (0.1% ropivacaine with 0.3 µg/mL of sufentanil; 10 mL every 45 min at 360 mL/h). The primary outcome was ropivacaine consumption per hour, calculated as the total amount of ropivacaine administered divided by the duration of labor analgesia (mg/h).
Results: Median ropivacaine consumption per hour was not significantly different: 12.6 mg/h [11.6-13.2 mg/h] for single-orifice vs 12.8 mg/h [12.3-13.3 mg/h] for multi-orifice catheters (difference 29%; 95% confidence interval [CI], -10.2 to 68.2%; P=0.241). No significant differences were found in patient-controlled epidural analgesia boluses requested and delivered, time to first bolus request, or the number of clinician-administered boluses. However, adequate analgesia at 20 min was higher with single-orifice catheters (84.0% vs 63.5%, difference 22.5%; 95% CI: 9.2% to 35.1%, P=0.019). Median times to adequate analgesia were 8 min [4-16] vs 15 min [9.5-22.5] for single- and multi-orifice catheters (P=0.002). Pain scores differed only at 6 and 18 min. There were no differences in the incidence of motor or unilateral block, side effects, maternal satisfaction, or catheter-related complications between the two groups.
Conclusion: Single-orifice catheters did not enhance analgesia quality during labor maintenance under a 360-mL/h programmed intermittent epidural bolus delivery rate but were linked to more rapid analgesic onset than multi-orifice catheters.
期刊介绍：
Drug Design, Development and Therapy is an international, peer-reviewed, open access journal that spans the spectrum of drug design, discovery and development through to clinical applications.
The journal is characterized by the rapid reporting of high-quality original research, reviews, expert opinions, commentary and clinical studies in all therapeutic areas.
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Drug target identification and validation
Phenotypic screening and target deconvolution
Biochemical analyses of drug targets and their pathways
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Distribution, pharmacokinetics and metabolic transformations of drugs or biologically active compounds in drug development
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Preclinical development studies
Translational animal models
Mechanisms of action and signalling pathways
Toxicology
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Personalized medicine and pharmacogenomics
Clinical drug evaluation
Patient safety and sustained use of medicines.
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