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Recruiting NCT07473609

Failing Epidural Analgesia During Labor

— Observational Failed Epidural Analgesia Post-partum Recovery

For patients and families

In plain language

An automatic summary of structured registry data. It is an orientation aid, not a substitute for the official protocol or a physician assessment.

What is being studied
The protocol lists: No Intervention: Observational Cohort.
Who it may be relevant to
Registry conditions: Failed Epidural Analgesia, Post-partum Recovery. Basic parameters: from 18 years · Female.
What needs checking
Age, condition and sex are only basic indicators. Prior treatment, laboratory values and other mandatory requirements appear in the eligibility criteria below.
Where it takes place
Spain
Next step
Save the trial, show it to the treating physician, and confirm current recruitment with the study center. Costs, documents and travel →

Unsure about the terms? Read our patient guide →

Official title

Analysis of the Incidence and Risk Factors of Epidural Analgesia Failure During Labor: A Prospective Multicenter Observational Study

Overview

This prospective multicenter observational study is being conducted at the Gregorio Marañón University General Hospital and the La Paz University Hospital in Madrid, Spain. The recruitment period began on January 12, 2026, and will continue until February 12, 2027. Patients over 18 years of age requesting epidural analgesia for labor are included. Exclusion criteria are: age under 18; stillbirth; continuous spinal anesthesia; refusal to participate in the study. The primary objective of the study is to calculate the incidence of epidural analgesia failure during labor. Secondary objectives are: identification of potential risk factors for epidural analgesia failure; failure of epidural anesthesia for emergency cesarean birth; maternal postpartum recovery at 24 and 48 hours using the Spanish-validated version of ObsQoR-10 questionnaire.

Interventions

  • Other No Intervention: Observational Cohort
    No intervention: observational study

Primary outcome measures

  • Failed epidural analgesia during labor [Time frame: All duration of labour (from admission to labour ward until delivery) in patients with an initial adequate pain relief after epidural analgesia initiation.]
Secondary outcome measures (3)
  • Failed onset of epidural block [Time frame: An incomplete or inefficient block 30 minutes after initiation of epidural analgesia will be considered as a failed onset.]
  • Failed conversion of epidural analgesia to anesthesia for intrapartum cesarean birth [Time frame: In subpopulation of patients with an intrapartum cesarean delivery, failed conversion will be considered for any requirement for intravenous supplementation or general anaesthesia during caesarean delivery.]
  • Maternal recovery until 48h postpartum [Time frame: On postpartum day 1 (24h after delivery) and day 2 (48h after delivery), during post-partum anaesthesia visit, the participants will answer the 10-Items Obstetric Quality of Recovery scoring tool (ObsQoR-10).]

Eligibility criteria

Inclusion criteria

  • Parturient who requests epidural analgesia for labor

Exclusion criteria

  • Age under 18 years
  • Stillbirth
  • Continuous spinal anesthesia
  • Refusal to participate

Criteria are shown verbatim from the registry (in English). Final eligibility is always assessed by the study center.

Healthy volunteers: No

Study design

Observational model
Cohort

Study locations

Spain · 2 centers
  • Hospital General Universitario Gregorio Marañón — Madrid
  • Hospital Universitario La Paz — Madrid

Publications

  • Russell I. Technique of anaesthesia for caesarean section. In: Colvin J, editor. Raising the Standard: A Compendium of Audit Recipes for Continuous Quality Improvement in Anaesthesia. 2nd ed. London: RCA; 2006. p. 166-7.
  • Hermanides J, Hollmann MW, Stevens MF, Lirk P. Failed epidural: causes and management. Br J Anaesth. 2012 Aug;109(2):144-54. doi: 10.1093/bja/aes214. Epub 2012 Jun 26. PMID 22735301
  • Ministerio de Sanidad. Atención perinatal en España: Análisis de los recursos físicos, humanos, actividad y calidad de los servicios hospitalarios, 2010-2018 [Publicación en Internet]. Madrid. Ministerio de Sanidad, 2021.
  • WFSA recommendations: Declaration on Labour Analgesia: A Call for Global Access to Pain Relief During Childbirth; 2025. https://wfsahq.org/our-work/advocacy/campaigns/labour-analgesia-campaign/
  • Braithwaite J, Herkes J, Ludlow K, Testa L, Lamprell G. Association between organisational and workplace cultures, and patient outcomes: systematic review. BMJ Open. 2017 Nov 8;7(11):e017708. doi: 10.1136/bmjopen-2017-017708. PMID 29122796
  • Guevara J, Sanchez C, Organista-Montano J, Domingue BW, Guo N, Sultan P. Development and validation of a Spanish version of the Obstetric Quality of Recovery-10 item score (ObsQoR-10-Spanish). BJA Open. 2024 Mar 21;10:100269. doi: 10.1016/j.bjao.2024.100269. eCollection 2024 Jun. PMID 38560622
  • Sultan P, George R, Weiniger CF, El-Boghdadly K, Pandal P, Carvalho B; CRADLE Study Investigators. Expert Consensus Regarding Core Outcomes for Enhanced Recovery after Cesarean Delivery Studies: A Delphi Study. Anesthesiology. 2022 Aug 1;137(2):201-211. doi: 10.1097/ALN.0000000000004263. PMID 35511169
  • Handelzalts JE, Levy S, Krissi H, Peled Y. Epidural analgesia associations with depression, PTSD, and bonding at 2 months postpartum. J Psychosom Obstet Gynaecol. 2022 Dec;43(4):488-494. doi: 10.1080/0167482X.2022.2081146. Epub 2022 Jun 28. PMID 35762178

Identifiers

NCT: NCT07473609 · FEA25 · Contract # 25/26

Primary sources (government registries)

View this study on ClinicalTrials.gov ↗