PATIENT CONTROLLED EPIDURAL ANALGESIA versus CONTINUOUS INFUSION FOR LABOR PAIN RELIEF

Abstract

S371 Patient controlled epidural analgesia (PCEA) has been reported to be associated with decreased need for anesthetic drugs and less demand on staff time compared to continuous epidural infusion (CEI) [1]. This prospective randomized trial compared PCEA with CEI in a busy obstetric service. METHODS: The protocol was approved by the local review board and patients gave informed consent. Following the establishment of lumbar epidural analgesia (LEA) equal number of patients (n=22 per group) were assigned to PCEA or CEI mode. Patients received 0.125% bupivacaine with 2 [micro sign]g/ml fentanyl for both modes. The CEI group received an infusion at 10ml/hr. The PCEA group received a basal infusion at 6 ml/hr, a demand dose of 3 ml with a 10 min lockout. Hourly pain visual analog scores (VAS:0-100 mm), sensory/motor block, vital signs, number of interventions and time spent by anesthesia care provider, the total amount of drug, the time from LEA to 10 cm dilation and the duration of 2nd stage were noted. Results were expressed as mean +/- 1SE and analyzed using t-test or Mann-Whitney-U test at p<0.05. RESULTS: The PCEA patients used 3.36 +/- 0.2 demand injections. Nine and five additional injections were respectively required in CEI and PCEA groups for inadequate analgesia. No differences existed in VAS scores, sensory/motor block or other parameters between the groups. (Table 1).Table 1CONCLUSION: Our data show that both CEI and PCEA are equally effective in producing labor analgesia and that the use of PCEA may not necessarily decrease the total drug used or time spent by ACP for clinical care. No significant differences were noted between the groups. Inf - infusion; Epid - epidural; ACP - anesthesia care provider.