Skip to main content
Top
Published in: The Journal of Obstetrics and Gynecology of India 4/2011

01-08-2011 | Original Paper

Low Dose Epidural Analgesia During Labor: Comparison Between Patient Controlled Epidural Analgesia with Basal Continuous Infusion and Intermittent Bolus Technique

Authors: Saroj Singh, Ankita Singh, Uma Srivastava

Published in: The Journal of Obstetrics and Gynecology of India | Issue 4/2011

Login to get access

Abstract

Objectives

To compare the efficacy and safety of patient controlled epidural analgesia with basal continuous infusion versus intermittent bolus for labor analgesia using fentanyl and bupivacaine.

Methods

In this prospective study, 60 parturients having singleton term uncomplicated pregnancy in early active labor were included. 30 parturients were allocated to receive patient controlled epidural analgesia + basal continuous infusion (Group-A) and 30 received intermittent bolus on demand (Group-B). Efficacy of technique was assessed in terms of quality of analgesia on 0–10 cm verbal analogue scale. Effect on labor was assessed by duration of labor, mode of delivery, and parturient’s satisfaction. Neonatal outcome was measured by Apgar score. Data were expressed as mean ± SD and analysed using Student ‘t’ test and chi square test where appropriate. P < 0.05 was considered statistically significant.

Results

Analgesic efficacy of both the groups was comparable. Maternal satisfaction was better in group A than in group B but the results did not achieve statistical significance. Effect on labor and neonatal outcome were comparable.

Conclusions

Both the techniques appear to be safe for the mother and neonate with excellent analgesic efficacy. In a busy obstetric unit with increased demand of epidural analgesia, patient controlled epidural analgesia with basal continuous infusion may be preferred.
Literature
1.
go back to reference Campbell DC. Labor analgesia; what’s new and PCEA too? Can J Anaesth. 2003;50:R8. Campbell DC. Labor analgesia; what’s new and PCEA too? Can J Anaesth. 2003;50:R8.
2.
go back to reference Fettes PDW, Moore CS, Whiteside JB, et al. Intermittent vs continuous administration of epidural ropivacaine with fentanyl for analgesia during labor. Br J Anaesth. 2006;97(3):359–64.PubMedCrossRef Fettes PDW, Moore CS, Whiteside JB, et al. Intermittent vs continuous administration of epidural ropivacaine with fentanyl for analgesia during labor. Br J Anaesth. 2006;97(3):359–64.PubMedCrossRef
3.
go back to reference Collis RE, Plaat FS, Morgan BM. Comparison of midwife top-ups, continuous infusion and patient controlled epidural analgesia for maintaining mobility after a low-dose combined spinal epidural. Br J Anaesth. 1999;82(2):233–6.PubMedCrossRef Collis RE, Plaat FS, Morgan BM. Comparison of midwife top-ups, continuous infusion and patient controlled epidural analgesia for maintaining mobility after a low-dose combined spinal epidural. Br J Anaesth. 1999;82(2):233–6.PubMedCrossRef
4.
go back to reference Salim R, Nachum Z, Moscovici R, et al. Continuous compared with intermittent epidural infusion on progress of labor and patient satisfaction. Obstet Gynecol. 2005;106:301–6.PubMedCrossRef Salim R, Nachum Z, Moscovici R, et al. Continuous compared with intermittent epidural infusion on progress of labor and patient satisfaction. Obstet Gynecol. 2005;106:301–6.PubMedCrossRef
5.
go back to reference D′Angelo R. Epidural PCA during labor. 2001, ASA Newsletter, 65(11). D′Angelo R. Epidural PCA during labor. 2001, ASA Newsletter, 65(11).
6.
go back to reference Nageotte MP, Larson D, Rumney PJ, et al. Epidural analgesia compared with combined spinal epidural analgesia during labor in nulliparous women. N Engl J Med. 1997;337:1715–9.PubMedCrossRef Nageotte MP, Larson D, Rumney PJ, et al. Epidural analgesia compared with combined spinal epidural analgesia during labor in nulliparous women. N Engl J Med. 1997;337:1715–9.PubMedCrossRef
7.
go back to reference Finegold H, Mandell G, Ramanathan S. Comparison of ropivacaine.1%—fentanyl and bupivacaine.125%—fentanyl infusion for epidural labor analgesia. Can J Anesth. 2000;47:740–5.PubMedCrossRef Finegold H, Mandell G, Ramanathan S. Comparison of ropivacaine.1%—fentanyl and bupivacaine.125%—fentanyl infusion for epidural labor analgesia. Can J Anesth. 2000;47:740–5.PubMedCrossRef
8.
go back to reference Sia AT, Lim Y, Ocampo C. A comparison of basal infusion with automated mandatory boluses in parturient-controlled epidural analgesia during labor. Anesh Analg. 2007;104:673–8.CrossRef Sia AT, Lim Y, Ocampo C. A comparison of basal infusion with automated mandatory boluses in parturient-controlled epidural analgesia during labor. Anesh Analg. 2007;104:673–8.CrossRef
9.
go back to reference Chen SH, Liou SC, Hung CT, et al. Comparison of patient-controlled epidural analgesia and continuous epidural infusion for labor analgesia. Chang Gung Med J. 2006;29:576–82.PubMed Chen SH, Liou SC, Hung CT, et al. Comparison of patient-controlled epidural analgesia and continuous epidural infusion for labor analgesia. Chang Gung Med J. 2006;29:576–82.PubMed
10.
go back to reference Theonaz N, Boselli E, Stoian A, et al. Role of background infusion during labor PCEA with 0.0625% levobupivacaine plus 0.5 μg/mL sufentanil. Am Soc Anesthesiol. 2006;105:A919. Theonaz N, Boselli E, Stoian A, et al. Role of background infusion during labor PCEA with 0.0625% levobupivacaine plus 0.5 μg/mL sufentanil. Am Soc Anesthesiol. 2006;105:A919.
11.
go back to reference Van der Vyver M, Halpern S, Joseph G. Patient controlled epidural analgesia versus continuous infusion for labor analgesia: a meta analysis. Br J Anaesth. 2002;89(3):459–65.PubMed Van der Vyver M, Halpern S, Joseph G. Patient controlled epidural analgesia versus continuous infusion for labor analgesia: a meta analysis. Br J Anaesth. 2002;89(3):459–65.PubMed
12.
go back to reference Halpern S. Recent advances in patient-controlled epidural analgesia for labor. Curr Opin Anaesthesiol. 2005;18:247–51.PubMedCrossRef Halpern S. Recent advances in patient-controlled epidural analgesia for labor. Curr Opin Anaesthesiol. 2005;18:247–51.PubMedCrossRef
Metadata
Title
Low Dose Epidural Analgesia During Labor: Comparison Between Patient Controlled Epidural Analgesia with Basal Continuous Infusion and Intermittent Bolus Technique
Authors
Saroj Singh
Ankita Singh
Uma Srivastava
Publication date
01-08-2011
Publisher
Springer-Verlag
Published in
The Journal of Obstetrics and Gynecology of India / Issue 4/2011
Print ISSN: 0971-9202
Electronic ISSN: 0975-6434
DOI
https://doi.org/10.1007/s13224-011-0059-y

Other articles of this Issue 4/2011

The Journal of Obstetrics and Gynecology of India 4/2011 Go to the issue