A new labour pain management system, the Epiva, is currently being tested at the KK Women's and Children's Hospital (KKH) which could lead to less pain during a natural childbirth by epidural anaesthesia. The technology behind the Epiva system is wholly owned by KKH and local medical technological firm, Innovfusion. In 2015 itself, the Department of Women's Anaesthesia at KKH directed an estimated 5,000 labour epidurals.

Administering epidural anaesthesia

The Epiva is a smart pump which can administer an epidural anaesthesia on the patient during a natural childbirth. It aims to slash any chance of ‘breakthrough pain’, and so far, results seem promising. The trial, which aims to have 3,000 participants, has already been tested on more than 200 women who are giving birth for the first time.

The ‘breakthrough pain’ experienced by these women during labour has dropped from 25% to 6% with the use of the Epiva system, according to KKH’s primary results. Women report such pain in the first place when a dose of epidural anaesthesia loses its potency, and the patient has to wait for the subsequent dose while in considerable labour pain.

The Epiva is able to track how many times a patient presses a button to administer the epidural anaesthesia. The more a patient presses the button, the more pain she is in, and the Epiva is able to increase the basal rate of the epidural anaesthesia in the following hour. Accordingly, the Epiva also lowers its dosage if a patient presses the button less often.

Positive feedback

The assistant head of the Department of Women's Anaesthesia at KKH, Dr Sng Ban Leong, indicated that the feedback on the Epiva system has been positive. “The plan is to implement this technology […] sometime in [2016],” said Dr Sng to The Straits Times. At the moment, standard systems which administer epidural anaesthesia are not able to accurately gauge the basal rate required by the patient.

The new system comes with another advantage. It can administer the pain relief drug twice as quickly as a standard epidural pump. It can further release 50 millilitres of epidural anaesthesia at one shot, easing patients’ pain more efficiently instead of relying on smaller doses over a period of time. KKH finds the new pain management system to be more efficient as a result.

“If you have a lot of patients in pain half the time, nurses will be running around managing it. If the pain is better managed, nurses can focus on other aspects of patient care,” said Mr Theodore Tan from the company, Biofactory, which is also involved in the new technology.

KKH owns five pumps, each with an S$8,000 price tag, and the hospital is looking at a further 30 pumps in 2016 once certification has been approved. The system could eventually be sold to other local and overseas hospitals in time. MIMS

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