E.1 Medical condition or disease under investigation |
E.1.1 | Medical condition(s) being investigated |
Episiotomy (inclusion of primiparous patients giving birth by instrumental delivery -Suzor forceps, vacuum extraction, Thierry spatulas with episiotomy). |
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E.1.1.1 | Medical condition in easily understood language |
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E.1.1.2 | Therapeutic area | Analytical, Diagnostic and Therapeutic Techniques and Equipment [E] - Anesthesia and Analgesia [E03] |
MedDRA Classification |
E.1.3 | Condition being studied is a rare disease | No |
E.2 Objective of the trial |
E.2.1 | Main objective of the trial |
To evaluate the effect of the infiltration of levobupivacaine versus placebo on perineal pain after episiotomy in patients under epidural anesthesia. |
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E.2.2 | Secondary objectives of the trial |
- Estimate the amount of analgesics taken in the first 48 hours, then in the first 15 days postpartum
- Evaluate the slowing down of the daily activities of patients within the first 15 days postpartum
- Assess the pain at J15 postpartum on a simple numeric scale
- Evaluate the healing of episiotomy at J15 postpartum |
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E.2.3 | Trial contains a sub-study | No |
E.3 | Principal inclusion criteria |
-Primiparous
-Vaginal delivery with instrumentation (Suzor forceps, vacuum extraction, Thierry spatulas), with episiotomy
-Fœtus In cephalic position
-Single pregnancy
-Patient at least 18 years old
-Term superior or equal to 37 weeks of amenorrhea
-Patient under epidural analgesia
-Patient affiliated to a social security scheme
-Patient having a good understanding of French |
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E.4 | Principal exclusion criteria |
-Ineffective epidural analgesia, defined as the need of an additional local anesthesia for episiotomy repair
- Perineal tear of 3rd and 4rd grade, according to the Anglo-saxon classification
- Contra-indication to levobupivacaine, paracetamol, ketoprofen
- Protocol participation refusal
- Postpartum hemorrhage requiring arterial embolization, reoperation (evacuation of a vaginal thrombus, vessel ligation, hysterectomy by laparotomy) or balloon Bakri® placement. |
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E.5 End points |
E.5.1 | Primary end point(s) |
Pain evaluation on a simple numeric scale (ENS)
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E.5.1.1 | Timepoint(s) of evaluation of this end point |
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E.5.2 | Secondary end point(s) |
- Need for analgesics and quantity of analgesics taken in addition to paracetamol in the first 48 hours postpartum (ketoprofen, nefopam).
- Need for analgesics and amount of analgesics taken on Day 15 postpartum
- Impact of pain secondary to episiotomy on the daily life activities on Day1, Day2 and Day15 after delivery (sitting, walking, urinating, sleep, child care).
- ENS on Day 15 post-partum
- Control of episiotomy healing at Day15 post partum |
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E.5.2.1 | Timepoint(s) of evaluation of this end point |
- Need for analgesics :in the first 48 hours postpartum
- Need for analgesics : on Day 15 postpartum
- Impact of pain secondary to episiotomy on the daily life activities: Day1, Day2 and Day15 after delivery
- ENS on Day 15 post-partum
- Control of episiotomy healing at Day15 post partum |
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E.6 and E.7 Scope of the trial |
E.6 | Scope of the trial |
E.6.1 | Diagnosis | No |
E.6.2 | Prophylaxis | No |
E.6.3 | Therapy | No |
E.6.4 | Safety | No |
E.6.5 | Efficacy | Yes |
E.6.6 | Pharmacokinetic | No |
E.6.7 | Pharmacodynamic | No |
E.6.8 | Bioequivalence | No |
E.6.9 | Dose response | No |
E.6.10 | Pharmacogenetic | No |
E.6.11 | Pharmacogenomic | No |
E.6.12 | Pharmacoeconomic | No |
E.6.13 | Others | No |
E.7 | Trial type and phase |
E.7.1 | Human pharmacology (Phase I) | No |
E.7.1.1 | First administration to humans | No |
E.7.1.2 | Bioequivalence study | No |
E.7.1.3 | Other | No |
E.7.1.3.1 | Other trial type description | |
E.7.2 | Therapeutic exploratory (Phase II) | Yes |
E.7.3 | Therapeutic confirmatory (Phase III) | No |
E.7.4 | Therapeutic use (Phase IV) | No |
E.8 Design of the trial |
E.8.1 | Controlled | Yes |
E.8.1.1 | Randomised | Yes |
E.8.1.2 | Open | No |
E.8.1.3 | Single blind | No |
E.8.1.4 | Double blind | Yes |
E.8.1.5 | Parallel group | Yes |
E.8.1.6 | Cross over | No |
E.8.1.7 | Other | No |
E.8.2 | Comparator of controlled trial |
E.8.2.1 | Other medicinal product(s) | No |
E.8.2.2 | Placebo | Yes |
E.8.2.3 | Other | No |
E.8.2.4 | Number of treatment arms in the trial | 2 |
E.8.3 |
The trial involves single site in the Member State concerned
| Yes |
E.8.4 | The trial involves multiple sites in the Member State concerned | No |
E.8.5 | The trial involves multiple Member States | Yes |
E.8.5.1 | Number of sites anticipated in the EEA | 2 |
E.8.6 Trial involving sites outside the EEA |
E.8.6.1 | Trial being conducted both within and outside the EEA | No |
E.8.6.2 | Trial being conducted completely outside of the EEA | No |
E.8.7 | Trial has a data monitoring committee | No |
E.8.8 |
Definition of the end of the trial and justification where it is not the last
visit of the last subject undergoing the trial
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E.8.9 Initial estimate of the duration of the trial |
E.8.9.1 | In the Member State concerned years | 2 |
E.8.9.1 | In the Member State concerned months | |
E.8.9.1 | In the Member State concerned days | |
E.8.9.2 | In all countries concerned by the trial years | 2 |