A randomised non-inferiority controlled trial of a single versus a four intradermal sterile water injection technique for relief of continuous lower back pain during labour

BMC Pregnancy and Childbirth

Study Protocol

Michael Beckmann¹  Vanessa Wright¹  Sue Kildea²  Nigel Lee²  Peter Coxeter³  Joan Webster⁴  Tric Smith⁴ 

[1] Mater Health Services, 4101, South Brisbane, Qld, Australia;Mater Health Services, 4101, South Brisbane, Qld, Australia;Australian Catholic University, 4014, Banyo, Qld, Australia;Mater Medical Research Institute, 4101, South Brisbane, Qld, Australia;Royal Brisbane and Women's Hospital, 4029, Herston, Qld, Australia;

关键词: Visual Analogue Scale;    Visual Analogue Scale Score;    Human Research Ethic Committee;    Posterior Superior Iliac Spine;    Noninferiority Margin;   

DOI  :  10.1186/1471-2393-11-21

 received in 2010-12-17, accepted in 2011-03-23,  发布年份 2011

来源: Springer

【 摘 要 】

BackgroundAlmost one third of women suffer continuous lower back pain during labour. Evidence from three systematic reviews demonstrates that sterile water injections (SWI) provide statistically and clinically significant pain relief in women experiencing continuous lower back pain during labour. The most effective technique to administer SWI is yet to be determined. Therefore, the aim of this study is to determine if the single injection SWI technique is no less effective than the routinely used four injection SWI method in reducing continuous lower back pain during labour.Methods/designThe trial protocol was developed in consultation with an interdisciplinary team of clinical researchers. We aim to recruit 319 women presenting at term, seeking analgesia for continuous severe lower back pain during labour. Participants will be recruited from two major maternity hospitals in Australia. Randomised participants are allocated to receive a four or single intradermal needle SWI technique. The primary outcome is the change in self-reported pain measured by visual analogue scale at baseline and thirty minutes post intervention. Secondary outcomes include VAS change scores at 10, 60, 90 and 120 min, analgesia use, mode of birth and maternal satisfaction.Statistical analysisSample size was calculated to achieve 90% power at an alpha of 0.025 to detect a non-inferiority margin of ≤ 1 cm on the VAS, using a one-sided, two-sample t-test. Baseline demographic and clinical characteristics will be analysed for comparability between groups. Differences in primary (VAS pain score) and secondary outcomes between groups will be analysed by intention to treat and per protocol analysis using Student's t-test and ANOVA.ConclusionThis study will determine if a single intradermal SWI technique is no less effective than the routinely used four injection technique for lower back pain during labour. The findings will allow midwives to offer women requesting SWI during labour an evidence-based alternative technique more easily administered by staff and accepted by labouring women.Trial RegistrationACTRN12609000964213

【 授权许可】

CC BY   
© Lee et al; licensee BioMed Central Ltd. 2011