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> Procedures > Therapeutic or Preventive Procedure > Analgesia, Epidural

Analgesia, Epidural

Analgesia, Epidural: A type of regional anesthesia where an analgesic medication is administered into the epidural space of the spinal cord to provide pain relief.
This technique is commonly used during childbirth, surgeries, and for the management of chronic pain conditions.
Epidural analgesia can offer effective pain control with reduced systemic side effects compared to opioid-based medications.
Researchers can leverage AI-driven platforms like PubCompare.ai to optimize theri epidural analgesia research protocols, locate the best published methods, and ensure reproducibility and accuracy of their findings.

Most cited protocols related to «Analgesia, Epidural»

1
Postpartum Depression Risk Factors Study
This prospective cohort study was a secondary analysis of data collected from a clinical trial investigating the efficacy of different epidural delivery–maintenance regimens. The study was conducted between January 2015 and March 2019 in KK Women’s and Children’s Hospital, Singapore on parturients who received epidural analgesia for labor. The study protocol was developed according to the Strengthening the Reporting of Observational studies in Epidemiology (STROBE) guidelines on reporting cohort studies. The study was reviewed and approved by the SingHealth Centralized Institutional Review Board, Singapore (SingHealth CIRB ref 2014/670/D or 2018/3128), and registered on ClinicalTrials.gov (NCT02278601) on October 26, 2014.
The study included nulliparous parturients aged 21–50 years, 36 gestational weeks or more, with a singleton fetus, American Society of Anesthesiologists’ physical status I and II, and in early labor (cervical dilation <5 cm) who had requested epidural labor analgesia. Parturients with multiple pregnancies, noncephalic fetal presentation, obstetric complications (eg, preeclampsia, premature rupture of membranes), contraindications to neuraxial blockade, had received parenteral opioids within 2 hours prior to initiation of epidural analgesia, or had suspected inadvertent dural puncture during initiation of epidural analgesia were excluded.
All epidurals utilized the B Braun Espocan set with a combined spinal–epidural technique using a conventional single interspace needle-through-needle approach. The spinal component was ropivacaine 2mg and fentanyl 15mcg and the epidural infusion solution 0.1% ropivacaine with 2µg/mL of fentanyl. Almost all cases (>99%) were done in the sitting position and utilized a midline approach. The clinical trial involved patients who were placed on patient-controlled epidural analgesia regimens with patient bolus of 5mL per bolus. Once the patient had received epidural labor analgesia and was comfortable, predelivery questionnaires were administered: the PCS, a validated self-reported questionnaire to evaluate the negative thought processes that one may have upon exposure to actual or anticipated pain or painful experiences; the EPDS, a ten-item self-reported questionnaire used as a screening tool for antenatal and PND, scored from 0 to 30, with ≥10 used to indicate clinically significant depressive symptoms15 (link),16 (link) (in our study, this was defined as probable PND and would thus encompass the range of PND states);17 (link) Cohen’s Perceived Stress Scale (PSS), a ten-item validated psychometric instrument to quantify the perception of stress; and Spielberger’s State–Trait–Anxiety Inventory (STAI), a 40-item self-report tool that assesses transient anxiety (state) at the moment of scoring, the dispositional anxiety (trait), and anxiety in general. Parturients’ demographic, obstetric, and epidural analgesia data from medical records were also collected in this study. After patients had delivered, they were interviewed by the anesthetic team for assessment of overall satisfaction with epidural analgesia, as per routine clinical practice. A 20-minute phone survey was conducted at 5–9 weeks postdelivery to obtain postdelivery EPDS and STAI scores.
Zeng Y., Tan C.W., Sultana R., Chua T.E., Chen H.Y., Sia A.T, & Sng B.L. (2020). Association of Pain Catastrophizing with Postnatal Depressive States in Nulliparous Parturients: A Prospective Study. Neuropsychiatric Disease and Treatment, 16, 1853-1862.
Publication 2020
Analgesia, Epidural Anesthesiologist Anesthetics Anxiety Central Nervous System Dilatations, Cervical Ethics Committees, Research Fentanyl Fetal Membranes, Premature Rupture Fetus Mental Processes Needles Neuroses, Anxiety Obstetric Delivery Obstetric Labor Opioids Pain Parenteral Nutrition Patient-Controlled Analgesia Patients Physical Examination Pre-Eclampsia Pregnancy Psychometrics Punctures Ropivacaine Satisfaction Transients Treatment Protocols Woman
2
Perinatal Pain and Postpartum Depression
For the primary analysis, unadjusted associations between PIP and EPDS scores were assessed using simple linear regression. Confounders for the association between PIP and EPDS were determined using a >10% change in unadjusted and adjusted coefficients. Multiple linear regression was used to identify the best model for assessing the association between pain improvement and depression, after adjusting for history of anxiety or depression, other psychiatric history, abuse, trauma, mode of delivery, perineal lacerations during delivery, BMI, and other maternal or fetal co-morbid disease, specifically hypertensive disorders, history of miscarriage, anemia, chronic pain, or other disease including fetal anomalies. The percentage variability in EPDS explained by PIP, anxiety or depression, anemia, BMI, high-degree lacerations, and the full model was estimated by partial R2 coefficients. We examined a priori hypothesized interactions between PIP and the covariates BMI, a history of anxiety or depression, and a history of other psychiatric disorders. Collinearity in the final model was detected using variance inflation factor (VIF) >10.
For secondary analyses, because EPDS is clinically used as a screening tool, wherein a “positive” screen (EPDS ≥10) is referred for further evaluation, we explored the relationship between PIP and risk for depression as dichotomized to “positive” and “negative” screens, multivariable logistic regression was used to determine whether EPDS ≥10 and PIP were significantly associated after adjusting for a history of anxiety/depression and high-degree lacerations.
A sensitivity analysis was performed to assess the potential influence that extremes of missing intrapartum pain scores would have on the results from our multivariable model. Data were assumed to be missing completely at random. Data were imputed over two assumptions: a “best” scenario in which missing pain data were assumed to be greatest possible improvements in pain, and a “worst” scenario in which missing pain data were assumed to be lowest possible improvements in pain. Simple regression was used to determine and compare the relationship between PIP and EPDS for these two assumptions.
We assessed the influence of time (i.e., duration of labor) on PIP and EPDS, by both computing time-weighted pain and analgesia scores, and by adding duration of labor to the multivariable model. For this study, duration of labor was defined as the time of initiation of labor epidural analgesia until the time of delivery. The interaction between time and PIP and EPDS was also evaluated. Time-weighted pain and analgesia scores were computed to address the limitation of variable sampling intervals for pain scores during labor. Time-weighted NRS pain scores (pain) was the sum of the product of the average NRS and the time period during which NRS were recorded, divided by the sampling interval:13 (link)Time-weighted PIP (analgesia) was calculated as the difference between the time-weighted pain score and baseline pain, divided by baseline pain, expressed as a percentage. As with the primary analysis, changes in coefficients and effects of variable additions on the overall model were assessed.
One-way ANOVA was conducted to determine if baseline pain scores and PIP were different for groups with different anxiety/depression histories. Data distribution were assessed using box plots and histograms. Cohort characteristics were compared between missing and non-missing subjects using Fisher’s exact test, the unpaired, two-sample Student t-test, and the Mann-Whitney U test where appropriate. All tests performed were two-sided. A P-value < 0.05 was considered statistically significant. Analyses were performed using StataSE 14.0SE, StataCorp LP, 1985, College Station, TX.
The primary outcome was EPDS score and the predictor variable of interest was PIP. Considering that ten events per variable are conventionally required to be analyzed in regression,12 (link) and given anticipated analysis of 15 potential variables, 150 events (cases) would be required. We estimated that missing data would occur in this chart review at a rate of approximately 33%; therefore, we aimed to include a minimum total of 200 cases in the primary analysis. A power analysis for linear regression was conducted in XLSTAT (Microsoft Inc., USA) using an alpha of 0.05, number of tested predictors of 15 and a moderate effect size (f2 = 0.15). With 201 cases, we had 90% power to detect a significant association between PIP and EPDS.
Lim G., Farrell L.M., Facco F.L., Gold M.S, & Wasan A.D. (2018). Labor Analgesia as a Predictor for Reduced Postpartum Depression Scores: A Retrospective Observational Study. Anesthesia and analgesia, 126(5), 1598-1605.
Publication 2017
Analgesia, Epidural Anemia Anxiety Chronic Pain Drug Abuse Fetal Anomalies Fetal Diseases High Blood Pressures Hypersensitivity Labor Pain Laceration Management, Pain Mental Disorders Mothers neuro-oncological ventral antigen 2, human Obstetric Delivery Obstetric Labor Pain Perineum Spontaneous Abortion Student Wounds and Injuries
3
Integrated Pulmonary Index Database Creation
Datasets of continuous recordings (sample rate at least 1 s) of PetCO2, RR, SpO2, and PR in a variety of clinical environments were used to create a clinical database (Table 2). This data was obtained from previous clinical trials in humans sponsored by the company and all had approval of ethics committees. IPI values were then calculated for each patient data set throughout the data recording. Inclusion criteria into the new database were the continuous recording of all four parameters for at least 10 consecutive minutes. This new database was then subjected to further analysis.

Studies comprising clinical data used in the retrospective analysis

Studies comprising clinical databaseStudy description
1.Quantitative and Qualitative Assessment of the Frequency and Validation of Alarms on the Alaris Medical PCA system with Oridion EtCO2 module, conducted at St Joseph’s Candler Health System, Savannah GAPrincipal investigator: Ray Maddox, PharmDArea of care: General Floor
2.Smart Respiratory index—Clinical Evaluation Plan conducted at Hadassah University Medical Center in Jerusalem, IsraelPrincipal investigator: Dr. David Gozal. MDArea of care: Pediatric Gastroenterology under procedural sedation
3.Quantitative and Qualitative Assessment During an Upper Endoscopy Procedure of the Oxygen Delivery and EtCO2 sampling with the Smart Bite Bloc Mark III with oral O2 Delivery conducted at Bikur Holim Medical Center in Jerusalem, IsraelPrincipal investigator: Prof. Samuel AdlerArea of care: Adult Gastroenterology under procedural sedation
4.Validation of the Oridion Capnography System in the PrehosPital and Emergency Department SettingConducted at U.S. Army Institute of Surgical Research, Texas, USAPrincipal investigator: Dr. Jose Salinas, PhDArea of care: Adult trauma—EMS
5.Smart ResPiratory index—Clinical Evaluation Plan (Hadassah), conducted at Hadassah University Medical Center in Jerusalem, IsraelPrincipal investigator: Dr. David Gozal MDArea of care: Procedural Sedation
6.Quantitative and Qualitative Assessment of the IPI set in Sha’are Zedek Medical Center, conducted at Sha’are Zedek Medical Center in Jerusalem, IsraelPrincipal investigator: Prof. Yaacov Gozal MDArea of care: Post Anesthesia Care
7.Comparison of the efficacy and safety of intravenous remifentanil PCA and epidural PCEA for labor analgesia. Conducted at the EPidural PCEA for labor analgesia, Jerusalem, IsraelPrincipal investigator: Dr. Carolyn F Weiniger MD MRCA.Area of care: labor analgesia
8.Capnography Library−data collection in the critical care environment, conducted at Shaare-Zedek Medical Center in Jerusalem, IsraelPrincipal investigator: Dr. Sharon Einav MDArea of care: ICU
9.A Pilot investigation to investigate the influence of CO2 sampling site on measured exhaled carbon dioxide during non-invasive pressure ventilation (NPPV)’. Conducted at Medical College of Georgia, Augusta, GA, USAPrincipal investigator: Arthur A. Taft, PhD., RRTArea of care: ICU
10.Prospective Observational Clinical Trial to Investigate the Clinical Utility of the Integrated Pulmonary Index ™ (IPI™) to Predict Ability to Wean from Mechanical Ventilation’. Conducted at the Rush University Medical Center, Chicago, IL, USAPrincipal investigator: David Vines, MHS, RRTArea of care: ICU
11.A Pilot investigation to investigate the influence of CO2 sampling site on measured exhaled carbon dioxide during non-invasive pressure ventilation (NPPV)’. Conducted at The University of Alabama at Birmingham, Birmingham, AL, USAPrincipal investigator: Arthur A. Taft, PhD., RRTArea of care: ICU
Ronen M., Weissbrod R., Overdyk F.J, & Ajizian S. (2016). Smart respiratory monitoring: clinical development and validation of the IPI™ (Integrated Pulmonary Index) algorithm. Journal of Clinical Monitoring and Computing, 31(2), 435-442.
Publication 2016
Adult Analgesia, Epidural Anesthesia Capnography Carbon dioxide cDNA Library Critical Care Dental Occlusion Epidural Anesthesia Ethics Committees Gastroscopy Homo sapiens Lung Management, Pain Mechanical Ventilation Noninvasive Ventilation Obstetric Delivery Obstetric Labor Operative Surgical Procedures Patients Pressure Remifentanil Respiratory Rate Safety Saturation of Peripheral Oxygen Wounds and Injuries
4
Predicting Postoperative Respiratory Complications
Through the incorporation of data from the Anesthesia Information Management System and research patient data registry databases, we obtained data on the personal characteristics of our study population, including sex, age, height, body mass index, and American Society of Anesthesiologists physical status classification. To control for patient comorbidities, we used billing data to calculate the Charlson comorbidity index, as well as to identify patients with existing chronic pulmonary disease.19 (link) For all patients we calculated the score for prediction of postoperative respiratory complications, which is a previously validated score used to determine a patient’s risk of postoperative respiratory complications.20 (link)
We controlled for surgical procedure by using current procedural terminology codes to first categorize abdominal procedures into four groups based on a previously published classification system: laparoscopic, major, minor or hernia repair, and retroperitoneal.21 (link) The remaining sample was divided into the categories listed in table 1 using current procedural terminology codes and the listed surgical service. To adjust for surgical complexity we collected the work relative value units for each surgical operation within our sample.22 (no link found, link) Current procedural terminology codes assigned a work relative value unit of zero are for procedure descriptions that are non-specific and were excluded from the dataset.23 (link) We also obtained data related to a patient’s individual procedure, such as duration of ventilation, use of epidural analgesia, transfusion of blood products, estimated blood loss, and whether the surgery was scheduled as emergent/urgent or ambulatory.
Ladha K., Vidal Melo M.F., McLean D.J., Wanderer J.P., Grabitz S.D., Kurth T, & Eikermann M. (2015). Intraoperative protective mechanical ventilation and risk of postoperative respiratory complications: hospital based registry study. The BMJ, 351, h3646.
Publication 2015
Abdomen Analgesia, Epidural Anesthesia Anesthesiologist Blood Transfusion Hemorrhage Herniorrhaphy Index, Body Mass Laparoscopy Lung Diseases Operative Surgical Procedures Patients Physical Examination Postoperative Complications Respiratory Rate Retroperitoneal Space
5
Observational Study of Nurse-Midwifery Care Processes and Outcomes
The Oregon Health & Science University (OHSU) certified nurse-midwifery (CNM) practice has been at OHSU for 43 years. CNMs in this practice attend approximately 600 women during birth annually and are licensed, independent practitioners who consult as needed with other providers. Since 2012, the OHSU CNM faculty has been collecting observational data about women receiving care with this practice. This data collection was initiated for quality improvement and received OHSU Institutional Review Board (IRB) approval. Information is recorded at 3 points of clinical care: 1) the initial outpatient prenatal visit, 2) inpatient labor, birth, and postpartum care, 3) and the 6-week postpartum visit.
Data set questions are phrased to elicit unambiguous information, with most questions requiring a yes/no response such as ‘was epidural analgesia used for labor and/or birth?’ Non-binary questions require more information; e.g., ‘vaginal examination at time of amniotomy’ elicits response regarding effacement, dilation, and station (on a −1 to +5 scale). Questions were designed to gather a level of detail regarding midwifery clinical care processes and outcomes not easily captured by administrative or electronic health record data. For example, when the midwife indicates that an induction was initiated, she is prompted to specify all methods used for induction (i.e., acupuncture, amniotomy, Cervidil, Foley bulb, misoprostol, Pitocin, prostaglandin gel, herbs, castor oil).
All data forms collected for this prospective cohort are reviewed bi-weekly by a data entry team. CNM students, trained in data entry and verification, transfer data into the Research Electronic Data Capture (REDCap) system. Uncertainties or missing data were highlighted and addressed by the faculty who provided clinical care. Additionally, the CNM director compares a convenience sample (generally 10 cases) to the data recorded in the women’s electronic medical records twice monthly. This is accomplished both for ongoing quality assessment and to resolve any uncertainties or discrepancies.
Upon OHSU IRB approval to use this data repository for the current study, a de-identified sample was obtained. Ten percent of the sample was randomly selected for double-verification to assess accuracy between paper data collection forms, electronic medical records, and REDCap database. This process determined 99% data accuracy. All women in the study received antepartum and intrapartum care with the CNMs and met the following inclusion criteria: age 21 years or older, 37 or more weeks gestation, and in spontaneous labor with a singleton, non-anomalous, live, fetus in vertex presentation. We excluded women with a prior cesarean birth (Figure 1).
Providers recorded the date and time (in hours, minutes) when a woman self-reported onset of the latent phase. Providers also recorded the date and time (in hours, minutes) of active phase onset; this time point was used to define the termination of the latent phase. While cervical examination is frequently performed to determine active phase onset, cervical examination was not required for identifying transition to active phase. Within this practice, providers may rely on women’s symptoms or behavior, e.g., shaking, emesis, increased expression or reports of pain,7 ,23 ,24 to identify the transition from the latent to the active phase of labor. Active phase signs and symptoms are frequently more prominent when women labor without analgesia,25 (link) and 71% of women in this dataset did not use epidural anesthesia. Since the median years of practice of CNM providers was 31 years, the CNM team collecting data for this study was experienced in recognizing the transition from latent to active labor and also experienced in caring for a population of women in whom this transition is not masked by epidural use.
TILDEN E.L., PHILLIPPI J.C., AHLBERG M., KING T.L., DISSANAYAKE M., LEE C.S., SNOWDEN J.M, & CAUGHEY A.B. (2019). Describing latent phase duration and associated characteristics among 1281 low-risk women in spontaneous labor. Birth (Berkeley, Calif.), 46(4), 592-601.
Publication 2019
Analgesia, Epidural Artificial Rupture of Membranes Castor oil Cesarean Section Childbirth Epidural Anesthesia Ethics Committees, Research Faculty Inpatient Management, Pain Medulla Oblongata Midwife Misoprostol Neck Nurses Obstetric Labor Outpatients Pain Pathological Dilatation Pitocin Point-of-Care Systems Postnatal Care Pregnancy Prostaglandins Student Therapy, Acupuncture Vaginal Examination Vomiting Woman

Most recents protocols related to «Analgesia, Epidural»

1
Comparative Statistical Analysis of Surgical Outcomes
The statistical analysis of counting and measuring data was carried out using SPSS 23.0 statistical software (IBM, 2015, United States). Each variable’s normality was checked using the Kolmogorov-Smirnov and Shapiro-Wilk tests, and further tests were run as necessary. The age distribution of the two groups was compared using the unpaired Student’s t test. Mann-Whitney U test was used to compare the type of surgery. The ratio of male to female, smoking status, and usage of epidural analgesia were all compared between the two groups using the chi-square test. In order to compare key outcomes between the case and control groups, the Chi-square test was also applied. The primary result was compared between the ERAS group and the control group, both of which had spent more than 2 d in the hospital prior to surgery, using the Fischer precision test. Mann-Whitney U test was used to compare the length of postoperative hospital stay between the two groups (secondary outcome). On the 2nd and 4th d following surgery, the Wilcoxon rank-sum test was used to compare the Borg score. Statistics were considered significant for P values under 0.05.
Gu Y.X., Wang X.Y., Xu M.X., Qian J.J, & Wang Y. (2023). Analysis of the impact of ERAS-based respiratory function training on older patients’ ability to prevent pulmonary complications after abdominal surgery. World Journal of Gastrointestinal Surgery, 15(2), 201-210.
Publication 2023
Age Groups Analgesia, Epidural estrogen receptor alpha, human Males Operative Surgical Procedures Student Woman
2
Perioperative Management Protocol for Surgical Patients
Patients are administered 400 ml/50 g carbohydrate pre-surgery drink, premedicated and anesthetized according to the standardized protocol which defines: perioperative medication, fluid therapy, hemodynamic goals and management, diuresis, core temperature, transfusion threshold, and postoperative nausea, and vomiting prevention. The protocol also defines analgesia corresponding with randomization (including a detailed standard of care for thoracic epidural analgesia). All the data are recorded including the length of anesthesia and surgery, and a brief description of the type of surgery and observed radicality.
Postoperative care is standardized including postoperative analgesia corresponding with randomization, hemodynamic optimization, fluid therapy and transfusions, glycemic control, and postoperative nausea and vomiting management.
A detailed description of perioperative and postoperative management in all three arms of the study is displayed in Fig. 2. The patients with insufficient pain relief on the protocol medication will be provided rescue multimodal analgesia with a strong opioid and will be excluded from the final analysis of the CTCs.

Detailed protocol of perioperative management

All the data are recorded to the patient´s electronic CRF, using academic cloud operated software ClinData (https://clindata.imtm.cz), including pain intensity (using the Numerical Rating Scale) and sedation (using the Richmond Agitation-Sedation Scale), adverse effects and complications directly associated with PA, postoperative nausea and vomiting, core temperature, duration of postoperative ileus, laboratory tests, and cognitive function evaluation.
Berta E., Srovnal J., Dytrych P., Bruthans J., Ulrichova J., Prasil P., Vecera L., Gabrhelik T., Tolmaci B., Dusa J., Maca J., Mazancova M., Haiduk F., Kutej M., Ihnat P., Michalek P, & Hajduch M. (2023). Influence of opioid analgesia type on circulating tumor cells in open colorectal cancer surgery (POACC-1): study protocol for a prospective randomized multicenter controlled trial. BMC Anesthesiology, 23, 64.
Publication 2023
Analgesia, Epidural Analgesics, Opioid Anesthesia Arm, Upper Blood Transfusion Carbohydrates Cognition Diuresis Fluid Therapy Glycemic Control Hemodynamics Ileus Management, Pain Multimodal Imaging Operative Surgical Procedures Pain Patients Pharmaceutical Preparations Postoperative Care Postoperative Nausea Sedatives Severity, Pain
3
Colorectal Surgery Exclusion Criteria

- Intolerance or allergy to study drugs

- A history of previous colorectal surgery

- Active neoadjuvant therapy prior to enrollment

- Contraindications to epidural analgesia

- Another malignancy not in permanent remission

- Chronic opioid medication or opioid administration within 7 days preoperatively

- Immunosuppressive or corticosteroid therapy

- Surgery within 30 days preoperatively (except for minor procedures)

- Chronic or acute infections

Berta E., Srovnal J., Dytrych P., Bruthans J., Ulrichova J., Prasil P., Vecera L., Gabrhelik T., Tolmaci B., Dusa J., Maca J., Mazancova M., Haiduk F., Kutej M., Ihnat P., Michalek P, & Hajduch M. (2023). Influence of opioid analgesia type on circulating tumor cells in open colorectal cancer surgery (POACC-1): study protocol for a prospective randomized multicenter controlled trial. BMC Anesthesiology, 23, 64.
Publication 2023
Adrenal Cortex Hormones Analgesia, Epidural Drug Allergy Immunosuppressive Agents Infection Malignant Neoplasms Neoadjuvant Therapy Opioids Pharmaceutical Preparations Therapeutics
4
Optimizing Analgesia for Colorectal Cancer Surgery
The aim of the project is to identify optimal analgesia techniques for CR prevention in open radical CRC surgery. Also, the aim is to elucidate the mechanisms of metastasis with regard to the expression and activity of various receptor subtypes in cancer tissues and the effects of morphine and piritramide on these receptors. Therefore, we intend to perform a prospective, randomized, controlled, multicenter trial comparing the effects of epidural, morphine- and piritramide-based analgesia on CTCs presence and dynamics in radical open CRC surgery. Correlations between the type of PA and the number of CTCs in the early postoperative period will be studied. We formulated the following working hypotheses:

- Different methods of analgesia affect CTCs presence and metastasis following CRC surgery.

- In CRC patients, the number of CTCs in the early postoperative period correlates positively with metastasis and negatively with survival.

- Epidural analgesia has favorable effects on CTCs presence and metastasis compared with morphine- and piritramide-based PA.

- Piritramide-based PA has favorable effects on CTCs presence and metastasis compared with morphine-based PA.

Berta E., Srovnal J., Dytrych P., Bruthans J., Ulrichova J., Prasil P., Vecera L., Gabrhelik T., Tolmaci B., Dusa J., Maca J., Mazancova M., Haiduk F., Kutej M., Ihnat P., Michalek P, & Hajduch M. (2023). Influence of opioid analgesia type on circulating tumor cells in open colorectal cancer surgery (POACC-1): study protocol for a prospective randomized multicenter controlled trial. BMC Anesthesiology, 23, 64.
Publication 2023
Analgesia, Epidural Malignant Neoplasms Management, Pain Morphine Neoplasm Metastasis Operative Surgical Procedures Patients Pirinitramide Tissues
5
Optimizing Cancer Biomarker Detection
Power analysis and sample size calculation stem from our prospective pilot data in 57 patients (17 patients with morphine, 19 patients with epidural, and 21 patients with piritramide analgesia). In this pilot study, we found a significant reduction in the number of CEA-mRNA positive CTCs (CEA = carcinoembryonic antigen) in systemic blood in 35% of piritramide- versus morphine-receiving patients. To confirm this effect, we expect a 35% decrease in CTCs in systemic blood in this ongoing study. We aim to demonstrate the effect in the epidural/piritramide analgesia groups at the level of 20%. Based on the power of 0.8 and the first type error of 0.05, we calculated the minimum number of subjects in the group to be 37. In order to compensate for a potential dropout of 10%, we decided to enroll minimum 40 patients per group, i.e. minimum 120 patients in total.
Berta E., Srovnal J., Dytrych P., Bruthans J., Ulrichova J., Prasil P., Vecera L., Gabrhelik T., Tolmaci B., Dusa J., Maca J., Mazancova M., Haiduk F., Kutej M., Ihnat P., Michalek P, & Hajduch M. (2023). Influence of opioid analgesia type on circulating tumor cells in open colorectal cancer surgery (POACC-1): study protocol for a prospective randomized multicenter controlled trial. BMC Anesthesiology, 23, 64.
Publication 2023
Analgesia, Epidural BLOOD Carcinoembryonic Antigen Epidural Anesthesia Management, Pain Morphine Patients Pirinitramide RNA, Messenger Stem, Plant

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More about "Analgesia, Epidural"

Epidural analgesia, also known as regional anesthesia, is a widely used technique for pain management during childbirth, surgical procedures, and chronic pain conditions.
The process involves administering an analgesic medication into the epidural space surrounding the spinal cord, providing effective pain relief with reduced systemic side effects compared to opioid-based medications.
Researchers can leverage advanced AI-driven platforms like PubCompare.ai to optimize their epidural analgesia research protocols.
These platforms can help researchers locate the best published methods, protocols, and techniques from literature, preprints, and patents, ensuring the reproducibility and accuracy of their findings.
When conducting epidural analgesia research, researchers may utilize various statistical software packages, such as SAS version 9.4, Statistica 13.1, SPSS Statistics version 21, and the Statistical Package for Social Sciences for Windows, version 17.0.
These tools can aid in the analysis and interpretation of data related to epidural analgesia outcomes, patient responses, and the effectiveness of different techniques.
Additionally, researchers may explore the use of specialized software like Obstetrix, a comprehensive perinatal information management system, or Ketorax, a medication management system, to integrate epidural analgesia data and optimize patient care.
They may also leverage programming languages like R version 4.0.2 and statistical software like Stata 14 and Stata 13 to develop custom analyses and models.
By harnessing the power of these AI-driven platforms and statistical software, researchers can enhance their epidural analgesia research, optimize their protocols, and ensure the reproducibility and accuracy of their findings, ultimately contributing to the advancement of pain management techniques and patient care.