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Analgesia for 2nd Trimester Termination of Pregnancy

This study has been terminated.
(Recruitment difficulty)
Information provided by (Responsible Party):
Samuel Lunenfeld Research Institute, Mount Sinai Hospital Identifier:
First received: March 23, 2012
Last updated: October 9, 2014
Last verified: October 2014
There has been very little investigation into the management of pain from 2nd trimester termination of pregnancy or unexpected fetal loss. The standard of practice in North America is usually intravenous patient controlled analgesia (IV PCA), using a narcotic wuch as fentanyl. The goal of this study is to compare the quality of recovery after termination of pregnancy using fentanyl IV PCA or patient controlled epidural analgesia (PCEA), a standard of care for live births. The study will be conducted as a randomized controlled trial.

Condition Intervention
Pain Drug: bupivacaine, fentanyl Drug: fentanyl

Study Type: Interventional
Study Design: Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: None (Open Label)
Primary Purpose: Treatment
Official Title: Analgesia for 2nd Trimester Termination of Pregnancy: a Randomized Controlled Trial of Intravenous Versus Epidural Patient Controlled Analgesia

Resource links provided by NLM:

Further study details as provided by Samuel Lunenfeld Research Institute, Mount Sinai Hospital:

Primary Outcome Measures:
  • Quality of Recovery - 40 score on discharge [ Time Frame: up to 5 days ]
    The primary outcome of this study will be the difference between IV PCA and PCEA groups in aggregate score of Quality of Recovery - 40 on discharge from hospital.

Secondary Outcome Measures:
  • Duration of procedure [ Time Frame: 24 hours ]
    Duration of procedure from induction to abortion in hours

  • Pain score [ Time Frame: 24 hours ]
    Visual analog pain score every 30 minutes during procedure

  • Narcotic-related complications [ Time Frame: 24 hours ]
    Incidence of: nausea/vomiting, pruritis, sedation, respiratory depression.

  • Epidural-related complications [ Time Frame: 24 hours ]
    Incidence of: hypotension, dural puncture, local anesthetic toxicity, neurological complications.

  • Surgical intervention [ Time Frame: 24 hours ]
    Incidence of surgical intervention and any anesthetic required for intervention.

Enrollment: 42
Study Start Date: March 2012
Study Completion Date: January 2014
Primary Completion Date: January 2014 (Final data collection date for primary outcome measure)
Arms Assigned Interventions
Active Comparator: Epidural (PCEA)
bupivacaine, fentanyl
Drug: bupivacaine, fentanyl
10mL of 0.125% of bupivacaine plus 50 mcg fentanyl, injected through an epidural catheter.
Other Names:
  • bupivacaine: Marcaine
  • fentanyl: fentanyl citrate
Active Comparator: IV PCA
Intravenous fentanyl patient controlled analgesia
Drug: fentanyl
fentanyl IV PCA with boluses 25-50 mcg, 3-6 minute lockout.
Other Name: fentanyl citrate

Detailed Description:

Epidural analgesia is known to provide superior analgesia for labour with minimal maternal and fetal side effects. This mode of analgesia is not usually offered to patients who require termination of their pregnancies or who suffer unexpected fetal losses, although they go through labour and delivery with likely more difficult psychological circumstances.

We plan to compare patient controlled epidural analgesia (PCEA) with intravenous patient controlled analgesia (IV PCA), for 2nd trimester terminations of pregnancy. We hypothesize that PCEA provides better quality of recovery than IV PCA. The previously validated Quality of Recovery - 40 questionnaire will be used to measure a patient's quality of recovery. The results of this study will determine the optimal method of pain relief for late termination of pregnancy or fetal loss.


Ages Eligible for Study:   16 Years to 55 Years   (Child, Adult)
Sexes Eligible for Study:   Female
Accepts Healthy Volunteers:   Yes

Inclusion Criteria:

  • interruption of pregnancy between 12 and 23 6/7 weeks

Exclusion Criteria:

  • documented allergy to fentanyl or bupivacaine
  • coagulopathy
  • drug or narcotic abuse
  • contraindication to neuraxial analgesia
  • inability to comply with IVPCA or PCEA
  • inability to complete the QoR-40 questionnaire
  • TOP due to maternal problems
  Contacts and Locations
Choosing to participate in a study is an important personal decision. Talk with your doctor and family members or friends about deciding to join a study. To learn more about this study, you or your doctor may contact the study research staff using the Contacts provided below. For general information, see Learn About Clinical Studies.

Please refer to this study by its identifier: NCT01563835

Canada, Ontario
Mount Sinai Hospital
Toronto, Ontario, Canada, M5G1X5
Sponsors and Collaborators
Samuel Lunenfeld Research Institute, Mount Sinai Hospital
Principal Investigator: Jose CA Carvalho, MD Mount Sinai Hospital, New York
  More Information

Responsible Party: Samuel Lunenfeld Research Institute, Mount Sinai Hospital Identifier: NCT01563835     History of Changes
Other Study ID Numbers: 12-03
Study First Received: March 23, 2012
Last Updated: October 9, 2014

Keywords provided by Samuel Lunenfeld Research Institute, Mount Sinai Hospital:
Termination of pregnancy

Additional relevant MeSH terms:
Citric Acid
Anesthetics, Local
Central Nervous System Depressants
Physiological Effects of Drugs
Sensory System Agents
Peripheral Nervous System Agents
Analgesics, Opioid
Adjuvants, Anesthesia
Anesthetics, Intravenous
Anesthetics, General
Calcium Chelating Agents
Chelating Agents
Sequestering Agents
Molecular Mechanisms of Pharmacological Action processed this record on September 19, 2017