Evidence map›Paper›PMID 38300394›Full record

ArticlePain and therapy2024

Efficacy and Safety of Epidural Chloroprocaine for Breakthrough Pain During Labor Analgesia: A Prospective, Double-Blind, Randomized Trial.

Tianzhen Ji, Can Jiang, Hongxia Liu, Zhehao Cai, Rongrong Liu, Lei Xie, Cheng Xu

Open access · goldAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Pain and therapy, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
1.7field-weighted citation impact, top 18% 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

4 citing papers in PubMed, 3 citations in OpenAlex.

  1. Trial
  2. Trial
  3. Article
  4. Chloroprocaine EDJournal of pain research · 2025
    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

7 authors at 2 institutions in 1 country.

Tianzhen Ji *Department of Anesthesiology, Anhui Provincial Maternal and Child Health Hospital, Maternal and Child Medical Center of Anhui Medical University, Hefei, 230011, China.
Can Jiang *Department of Anesthesiology, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China.
Hongxia LiuDepartment of Anesthesiology, Anhui Provincial Maternal and Child Health Hospital, Maternal and Child Medical Center of Anhui Medical University, Hefei, 230011, China.
Zhehao CaiDepartment of Anesthesiology, Anhui Provincial Maternal and Child Health Hospital, Maternal and Child Medical Center of Anhui Medical University, Hefei, 230011, China.
Rongrong LiuDepartment of Anesthesiology, Anhui Provincial Maternal and Child Health Hospital, Maternal and Child Medical Center of Anhui Medical University, Hefei, 230011, China.
Lei XieDepartment of Anesthesiology, Anhui Provincial Maternal and Child Health Hospital, Maternal and Child Medical Center of Anhui Medical University, Hefei, 230011, China. xielei169@163.com.
Cheng XuDepartment of Anesthesiology, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China. xucheng303@sjtu.edu.cn.ORCID http://orcid.org/0009-0007-6926-1435
Anhui Medical University · CNShanghai Jiao Tong University · CN

Funding

National Natural Science Foundation of China 82100315Project on Maternal and Child Health Talents of Jiangsu Province No. zd2021-2-1
6 · The paper itself

Abstract

introductionA significant number of women who undergo neuraxial labor analgesia experience breakthrough pain. Prompt mitigation of breakthrough pain is essential to improve maternal and fetal outcomes. We evaluated epidural chloroprocaine compared with ropivacaine in alleviating labor breakthrough pain.

methodsWe performed a double-blind randomized controlled clinical trial between May and July 2023. Eligible parturients received epidural analgesia with ropivacaine and sufentanil. Those with breakthrough pain were randomized to receive either 0.125% epidural ropivacaine (group R) or chloroprocaine at concentrations of 0.5% (group C1), 1.0% (group C2), or 1.5% (group C3), all in a volume of 6 mL. The primary outcome was the treatment success rate, indicated by a decrease of at least 4 points on the numerical rating scale pain score 9 min after analgesic injection. Secondary outcomes and adverse effects were also recorded.

resultsOut of 323 patients receiving epidural analgesia, 192 experienced breakthrough pain. After exclusion of three patients because of protocol deviation, there were 47, 48, 47, and 47 patients in group R, C1, C2, and C3, respectively. Group C3 demonstrated a higher treatment success rate (39/47, 83.0%) in managing breakthrough pain than group R (26/47, 55.3%), group C1 (12/48, 25.0%), and group C2 (30/47, 63.8%) (p < 0.001). Group C3 had lower numerical rating scale scores at 6 and 9 min after injection and required fewer patient-controlled epidural boluses than other groups. In addition, group C3 reported greater satisfaction than the other groups (p < 0.001). No significant differences were observed in obstetric or neonatal outcomes across these groups.

conclusionParturients experiencing breakthrough pain could receive 1.5% epidural chloroprocaine, rather than lower chloroprocaine concentrations and ropivacaine, to achieve more rapid and better pain relief with higher patient satisfaction.

trial registrationChinese Clinical Trial Registry, ChiCTR2300071069, http://www.chictr.org.cn/index.aspx .

Indexed as

Breakthrough painChloroprocaineEpidural analgesiaLabor analgesiaRopivacaine

Identifiers

PMID38300394
PMCPMC10928033
OpenAlexW4391447096

What OpenQuestion holds

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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.