COMPARISON OF PATIENT CONTROLLED EPIDURAL ANALGESIA WITH CONTINUOUS EPIDURAL INFUSION FOR LABOUR ANALGESIA
Journal Title: Journal of Evolution of Medical and Dental Sciences - Year 2016, Vol 5, Issue 56
Abstract
We conducted a study to compare the efficacy and safety of Patient Controlled Epidural Analgesia (PCEA) with that of Continuous Infusion of Epidural Analgesia (CIEA) for maintenance of labour analgesia and evaluated the quality of analgesia and obstetric and safety outcomes. METHODS The study was a hospital-based prospective, randomised control trial on 80 parturients who had a normal antenatal period. Each parturient received 500-1000 mL lactated ringer solution Intravenously (IV) prior to initiating epidural blockade. Epidural catheter placement was performed in a standard manner and all patients received an initial dose of 8-10 mL bupivacaine 0.25%. Parturients self-administered 0.125% bupivacaine with fentanyl 2.5 µg/mL using PCA pumps programmed as follows: 4 mL bolus with a 20 mins Lockout Interval (LI). Group B received CIEA of 8 mL 0.125% bupivacaine with fentanyl 2.5/mL. Hourly assessments included: VAS scores for pain and satisfaction, sensory and motor block, analgesic supplements, bupivacaine and fentanyl consumption. RESULTS Data from 80 patients showed no differences among groups in pain relief. Maternal satisfaction was greater in PCEA group. Anaesthetic interventions by way of supplemental doses of Bupivacaine and Fentanyl in the PCEA group were minimal (4 and 2 vs 25 and 12 P <0.001) compared to CEI group. PCEA group received less local anaesthetic (5.2 vs 9.4 p <0.001) and few patients in PCEA group had motor weakness compared to CEI group (6 vs 17 p <0.05). Both methods were safe for mother and newborn. CONCLUSION Patients who received PCEA required less anaesthetic interventions, required lower doses of local anaesthetic, fentanyl and have less motor weakness than those who received CEI.
Authors and Affiliations
Sumaiah , Kassim , Sahajananda , Praveen Halagunaki
Keywords
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- EP ID EP123365
- DOI 10.14260/jemds/2016/884
- Views 88
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