What was the sampling technique used and what are the advantages and disadvantages of using that technique? The researchers used prospective, double-blind randomized study. The total population was made up of 80 nulliparous parturients who were into active labor. The parturients were assigned to their treatments via computer-generated random numbers. The study was double-blind because the anesthesiologist administering the analgesia did not know which treatment he/she would give until the time when anesthesia was to be given.
A double-blind random study is advantageous because it makes sure that the one receiving the treatment and the one who is administering the treatment has no knowledge on the nature of the treatment being received or given. The main disadvantage in this technique is if the differences in treatment administration could result in error-prone methodology. Was there randomization? After exclusion of subjects was carried out, the subjects were randomly assigned to treatments by a computer-generated random number assignment. The staffs administering the treatments were also randomized as to what treatment they would give. Was it biased?
The use of the exclusion criteria for the subjects that were to be part of the study reduced the bias. The use of the double-blind random technique removed more bias. Generally, bias was low. Describe the validity and power of the study Based on the researchers’ desired results, the expected sample size that will allow the detection of a doubling of sacral block to 50% in the DPE group, at 80% power and [alpha] = 0. 05 was 29 per group. However, to account for the potential reduction in effect size due to the use of labor analgesic concentrations of local anesthetics in this study, a sample size of 40 per group was used.
With more samples, the power and validity of this study was increased. Background information of the hypothesis The combined spinal epidural technique (CSE) is a popular method for relieving labor pain (Birnbach, 2004; Eltzschig, Lieberman, & Camann, 2003). The CSE technique also reduces epidural catheter failures and verifies epidural space proximity through the definitive return of cerebrospinal fluid (CSF). However, hemodynamic instability, fetal bradycardia, other side effects and complications due to the dural puncture and the administration of local anesthetics and opioids through the spinal canal are possible with the use of CSE.
The “dural puncture epidural” (DPE) technique potentially minimizes the risks of CSE analgesia. With DPE a dural puncture is carried out without the injection of intrathecal drugs; which are introduced instead only into the epidural space. This will measure epidural space proximity, improve hemodynamic stability, faster assessment of epidural catheter function, and more rapid onset, compared with the standard epidural technique. Hypothesis of the study
Null hypothesis: The Dural Puncture Epidural technique using a larger 25-G spinal needle will not improve the onset, sacral spread, and overall quality of labor analgesia compared to a conventional epidural analgesia technique. Alternate hypothesis (what the study really wants to prove): The Dural Puncture Epidural technique using a larger 25-G spinal needle will improve the onset, sacral spread, and overall quality of labor analgesia compared to a conventional epidural analgesia technique.