Evaluation of Objective Pain Measurement Device
Evaluation of Objective Pain Measurement Device
This study will attempt to objectively measure pain with an experimental device. The
 investigators will apply the device to measure patients "pain" due to uterine contractions
 during routine clinical care to correlate patients verbal pain ratings and analgesia
 requirements to that measured by the device.
Despite all the progress in our understanding of the basic mechanisms of pain, the gold
 standard for measuring pain is still a subjective verbal numeric rating scale rating (0-10)
 obtained from the individual reporting pain. This method is not objective and cannot be used
 in all patient populations. This study will attempt to objectively measure pain in laboring
 mothers with a pain measurement device. The investigators aim to 1) see correlation between
 pain scores from the device and actual pain scores reported by the patients and degree of
 nociceptive input (uterine contractions) and to 2) compare the device index score and pain
 scores (patient reported during uterine contractions) after two techniques different
 neuraxial blocks i.e. combined spinal epidural (CSE) and dural puncture epidural (DPE).
Inclusion Criteria:

 -  Age 18-45

 -  ASA 1 or 2 +/-E

 -  Patient requesting epidural labor analgesia

 -  Patient in active labor (cervical change, greater than or equal to 3 cm)

 -  Good toco tracing (clearly showing contractions at least every 5 minutes)

 -  Pain score greater than or equal to 3 out of 10 with contractions

 Exclusion Criteria:

 -  History of chronic pain

 -  History of chronic opioid use

 -  BMI > 45

 -  Allergy to sensor adhesive material, local anesthetic or opioids

 -  Contraindication to neuraxial block

 -  Patient on magnesium infusion

 -  Inability to give informed consent

 -  Severe co-morbidities