Comparison of continuous background infusion plus demand dose and demand-only parturient-controlled epidural analgesia (PCEA) using ropivacaine combined with sufentanil for labor and delivery

Bremerich, Dorothee H.; Waibel, Hansjörg; Mierdl, S.; Meininger, Dirk; Byhahn, Christian; Zwißler, Bernhard; Ackermann, Hanns

doi:10.1016/j.ijoa.2004.12.005

Cited by 60 publications

(40 citation statements)

References 21 publications

(65 reference statements)

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“…This result does not support prior findings despite the use of different techniques, 18 suggesting that satisfaction with analgesia requires increasing concentrations of local anesthetic as uterine contractility increases. However, this result is in agreement with some aspects of the studies by Bremerich et al 8 and Srivastava et al, 24 who found that basal perfusion was associated with lower incidences of distressing pain and rescue doses during the second stage.…”

Section: 22supporting

confidence: 93%

“…26 Accordingly, our findings suggest that most important than the concentration of the anesthetic 18 or the basal perfusion 8,24 it is possible that larger volumes administered with higher pressure in the epidural space may be necessary for the pelvic blockade during the second stage, and the role of basal perfusion may diminish.…”

Section: 22mentioning

confidence: 84%

“…[1][2][3][4] Additionally, PCEA leads to decreased anesthetic administration, smaller rescue doses, and a lower incidence of motor blockade. 2,[5][6][7][8] PCEA has been used during labor with or without continuous background infusion, 1,4,[7][8][9][10] with boluses of different volumes, and with variable lockout intervals.…”

Section: Introductionmentioning

confidence: 99%

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Effects of Local Anesthetic on the Time Between Analgesic Boluses and the Duration of Labor in Patient-Controlled Epidural Analgesia: Prospective Study of Two Ultra-Low Dose Regimens of Ropivacaine and Sufentanil

Costa-Martins¹,

Dias

Pereira

et al. 2015

Acta Med Port

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(1):70-76 RESUMOIntrodução: A patient-controlled epidural analgesia com baixas concentrações de anestésicos é eficaz na redução da dor de parto. O objectivo deste estudo foi comparar dois regimes de doses ultrabaixas de ropivacaína e sufentanil (0,1% ropivacaína associada a 0,5 µg.ml -1 sufentanil vs. 0,06% ropivacaína associada a 0,5 µg.ml -1 sufentanil) nos intervalos entre bólus e na duração do trabalho de parto. Material e Métodos: Neste estudo prospectivo não-randomizado, realizado entre Janeiro e Julho de 2010, dois grupos de parturientes receberam patient-controlled epidural analgesia: o Grupo I (n = 58; 1 mg.ml -1 ropivacaína + 0,5 µg.ml -1 sufentanil) e o Grupo II (n = 57; 0,6 mg.ml -1 ropivacaína + 0,5 µg.ml -1 sufentanil). Quando necessário administraram-se doses de resgate de ropivacaína na concentração definida para cada grupo e sem sufentanil. Registaram-se a dor, os consumos de analgésicos, as características do bloqueio neuroaxial, do trabalho de parto, do recém-nascido, e a satisfação materna. Resultados: A dose de ropivacaína foi maior no Grupo I (9,5 [7,7-12,7] No Grupo I observouse um aumento do intervalo de tempo entre bólus (beta = 32,61 min, 95% CI [25,39; 39,82], p < 0,001), enquanto no Grupo II se observou uma diminuição dos intervalos (beta = -1,40 min, 95% CI [-2,44; -0,36], p = 0,009). A duração do segundo estadio do trabalho de parto foi significativamente maior no Grupo I do que no Grupo II (78 min vs. 65 min, p < 0,001). Conclusões: As parturientes que receberam ropivacaína a 0,06% exibiram uma menor evidência de efeitos cumulativos e um segundo estadio do trabalho de parto mais rápido do que as que receberam ropivacaína a 0,1%. Palavras-chave: Analgesia Controlada pelo Doente; Analgesia Obstétrica; Dor do Parto; Ropivacaína; Sufentanil. ABSTRACTBackground: Patient-controlled epidural analgesia with low concentrations of anesthetics is effective in reducing labor pain. The aim of this study was to assess and compare two ultra-low dose regimens of ropivacaine and sufentanil (0.1% ropivacaine plus 0.5 µg.ml-1 sufentanil vs. 0.06% ropivacaine plus 0.5 µg.ml -1 sufentanil) on the intervals between boluses and the duration of labor. Material and Methods: In this non-randomized prospective study, conducted between January and July 2010, two groups of parturients received patient-controlled epidural analgesia: Group I (n = 58; 1 mg.ml -1 ropivacaine + 0.5 µg.ml -1 sufentanil) and Group II (n = 57; 0.6 mg.ml -1 ropivacaine + 0.5 µg.ml -1 sufentanil). Rescue doses of ropivacaine at the concentration of the assigned group without sufentanil were administered as necessary. Pain, local anesthetic requirements, neuraxial blockade characteristics, labor and neonatal outcomes, and maternal satisfaction were recorded. Results: The ropivacaine dose was greater in ] mg.h -1 vs. 6.1 [5.1-9.8 mg.h -1 ], p < 0.001). A time increase between each bolus was observed in Group I (beta = 32.61 min, 95% CI [25.39; 39.82], p < 0.001), whereas a time decrease was observed in Group II (beta = -1.40 min, 95% CI ...

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Section: 22supporting

confidence: 93%

Section: 22mentioning

confidence: 84%

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Effects of Local Anesthetic on the Time Between Analgesic Boluses and the Duration of Labor in Patient-Controlled Epidural Analgesia: Prospective Study of Two Ultra-Low Dose Regimens of Ropivacaine and Sufentanil

Costa-Martins¹,

Dias

Pereira

et al. 2015

Acta Med Port

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“…Auch eine Studie, die sich mit dem Vergleich von früher und spä- [85][86][87][88][89][90]. Es konnte ein besseres Ergebnis der PCEA gezeigt werden, wenn eine basale epidurale Hintergrundinfusion mit Lokalanästhetika gegeben wurde [91][92][93][94][95]. In Bezug auf motorische Blockade und Art der Entbindung konnten keine eindeutigen Ergebnisse in der Literatur gefunden werden [91][92][93][94][95][96].…”

Section: Optimaler Zeitpunkt Des Neuroaxialen Verfahrensunclassified

“…Es konnte ein besseres Ergebnis der PCEA gezeigt werden, wenn eine basale epidurale Hintergrundinfusion mit Lokalanästhetika gegeben wurde [91][92][93][94][95]. In Bezug auf motorische Blockade und Art der Entbindung konnten keine eindeutigen Ergebnisse in der Literatur gefunden werden [91][92][93][94][95][96]. Ein neuer Therapieansatz ist die PIEB ("Programmed Intermittent Epidural Bolus", PIEB) und wird als Weiterentwicklung der PCEA gesehen.…”

Section: Optimaler Zeitpunkt Des Neuroaxialen Verfahrensunclassified