Evidence map›Paper›PMID 30633755›Full record

Trial reportPloS one2019

Electric stimulation-guided epidural analgesia for vaginal delivery: A randomized prospective study.

Chung Hun Lee, Sang Sik Choi, Mi Kyoung Lee, Jung Eun Kim, Dong Ik Chung, Mido Lee

Open access · goldAbstract readRandomized Controlled Trial
In one paragraph

Trial report in PloS one, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed, 1 pooled it
0.2field-weighted citation impact, top 46% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed, 1 synthesis or guideline pooled it, 4 citations in OpenAlex.

  1. Pooled it
  2. Trial
  3. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors at 1 institution in 1 country.

Chung Hun LeeDepartment of Anesthesiology and Pain medicine, Korea University Medical Center, Guro Hospital, Guro-Gu, Seoul, Republic of Korea.
Sang Sik ChoiDepartment of Anesthesiology and Pain medicine, Korea University Medical Center, Guro Hospital, Guro-Gu, Seoul, Republic of Korea.ORCID 0000-0002-0260-9886
Mi Kyoung LeeDepartment of Anesthesiology and Pain medicine, Korea University Medical Center, Guro Hospital, Guro-Gu, Seoul, Republic of Korea.
Jung Eun KimDepartment of Anesthesiology and Pain medicine, Korea University Medical Center, Guro Hospital, Guro-Gu, Seoul, Republic of Korea.
Dong Ik ChungDepartment of Anesthesiology and Pain medicine, Korea University Medical Center, Guro Hospital, Guro-Gu, Seoul, Republic of Korea.
Mido LeeDepartment of Anesthesiology and Pain medicine, Korea University Medical Center, Guro Hospital, Guro-Gu, Seoul, Republic of Korea.
Korea University Medical Center · KR

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThe failure rate of epidural anesthesia using the loss of resistance technique is 13-23%.

objectivesTo investigate the efficacy of epidural electric stimulation-guided epidural analgesia in vaginal delivery. STUDY

designAn open label randomized prospective study.

methodsLaboring women were randomized to two groups: epidural catheter insertion using only a loss of resistance technique or a loss of resistance technique with confirmation by electric stimulation. Catheters in both groups were initially tested with 3 ml of 1% lidocaine and those with any evidence of motor blockade were considered intrathecal. Sensory blockade and an 11 point numerical rating score for pain were assessed 30 minutes after administration of an epidural bolus of 10 ml of 0.22% ropivacaine with fentanyl. Successful epidural analgesia was defined as a decrease of 2 or more in the pain score and a bilateral L1-T10 sensory blockade.

resultsThirty-one patients were randomized to each group. The first 20 patients in each group were enrolled in a pilot study and were also included in the final analysis. One patient in the electric stimulation group was excluded owing to dural puncture by the Tuohy needle. One patient in each group demonstrated motor blockade after test dose and were considered failures. The number (% (95% confidence interval)) of successful cases were 29 out of 30 (97% (85, 100%)) in the electric stimulation group and 24 out of 31 (77% (61, 89%)) in the loss of resistance group (P = 0.053). However, analysis of only patients with absence of motor blockade revealed that 29 out of 29 (100% (92, 100%)) patients in the electric stimulation group and 24 of 29 (80% (63, 91%)) patients in the loss of resistance group had adequate analgesia (P = 0.024).

conclusionsAlthough limited by lack of blinding, small study size and inclusion of pilot study data, this study suggests epidural electric stimulation improves the success rate of subsequent labor analgesia.

Indexed as

AdultAnalgesia, EpiduralAnalgesia, ObstetricalAnesthetics, LocalElectric StimulationFemaleFentanylHumansLabor, ObstetricPilot ProjectsPregnancyProspective StudiesRopivacaineAnesthetics, LocalFentanylRopivacaine

Identifiers

PMID30633755
PMCPMC6329494
OpenAlexW2909059843

What OpenQuestion holds

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LicenceCC BY
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.