Labor analgesia: Comparison of epidural patient-controlled analgesia and intravenous patient-controlled analgesia

Süğür, Tayfun; Kızılateş, Esra; Kızılateş, Ali; İnanoğlu, Kerem; Karslı, Bilge

doi:10.14744/agri.2019.35403

Cited by 5 publications

(2 citation statements)

References 48 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Neuraxial analgesia is regarded as the most effective method to relieve labor pain all over the world as it can inhibit breakthrough pain of uterine contraction. 11 Epidural administration makes the blocking plane more manipulated than subarachnoid anesthesia, while low concentrated ropivacaine hardly impacts the nervus motorius of parturients, which makes epidural analgesia a most widespread approach for labor analgesia. 1 , 12 , 13 …”

Section: Discussionmentioning

confidence: 99%

The Effects of Different Puncture Points on Labor Analgesia Onset: Study Protocol for a Randomized Controlled Trial

Zhou,

Peng,

Chen

et al. 2023

JPR

View full text Add to dashboard Cite

Purpose Parturients suffer severe pain during the stages of labor, especially the first and second. Epidural anesthesia is an effective method to alleviate labor pain. L2-3, L3-4 and L4-5 spaces have been reported to be the recommendable puncture points owing to the adequate analgesia effect and high safety. However, the speed of pain alleviation via the three points has hardly been determined, which is of great importance to parturients. Thus, the aim of this study is to compare the onset time of parturients’ painless uterine contraction after epidural labor analgesia through different puncture points. Study Design and Methods It is a prospective, randomized, controlled, and subject- and assessor-blinded study. Totally, 150 subjects scheduled for vaginal delivery are going to be randomly assigned into the L2-3 and L3-4 group. Puncture point in L2-3 group is lumbar 2–3 space, while in L3-4 group it is lumbar 3–4 space. Analgesia initiation and maintenance are the same between the two groups. Primary outcome will be percentage of painless uterine contraction 15 min after epidural labor analgesia initiation. Secondary outcomes will be the sensory blocking level, motor blocking score, adverse effects of parturients, drug liquid consumption in unit interval, apgar score and degree of satisfaction of the parturients. Discussion This study estimates the onset time of parturients’ painless uterine contraction after epidural labor analgesia through L2-3 or L3-4 space. The results may provide a better choice to relieve labor pain as soon as possible.

show abstract

Section: Discussionmentioning

confidence: 99%

The Effects of Different Puncture Points on Labor Analgesia Onset: Study Protocol for a Randomized Controlled Trial

Zhou,

Peng,

Chen

et al. 2023

JPR

View full text Add to dashboard Cite

show abstract

“…However, because only small doses of opioids are used in epidural labor analgesia, the amount acting on gastrointestinal opioid receptors is very small. Accordingly, they have minimal inhibitory effects on the gastrointestinal tract [15].Therefore, the effect of epidural analgesia on gastric emptying during labor analgesia is mainly attributable to the reduction in pain rather than the opiates themselves. The net effect of epidural analgesia is thus more rapid gastric emptying.…”

Section: Discussionmentioning

confidence: 99%

Effects of epidural analgesia on gastric emptying in parturients monitored by ultrasound

Bu²,

Chen³

et al. 2022

Preprint

View full text Add to dashboard Cite

Background: Using B-ultrasound monitoring, we compared gastric emptying of semi-solid food between parturient women undergoing versus not undergoing epidural analgesia. Methods Eighty-six full-term, low-risk parturients were selected and divided into two groups according to epidural analgesia status: epidural analgesia group (LA, n = 66) and non-epidural analgesia group (NA, n = 20). The cross-sectional area of the gastric antrum (CSA0) was measured while fasting using B-ultrasound, and the time recorded as T0. The parturients in both groups then ate about 300 g millet congee (about 600 KJ). The CSAs of the gastric antra were measured by ultrasonography 60, 90, and 120 minutes after the experimental meal, these areas being recorded as CSA1, CSA2 and CSA3 and the corresponding time points as T1, T2, and T3. Pain scores of parturients at these four time points were recorded. Results CSA1, CSA2, and CSA3 were larger in the NA than in the LA group, and the gastric emptying time was longer in the NA than in the LA group (P < 0.05). Pain scores were higher in the NA than LA group at the three time points of T1, T2, T3 (P < 0.05). Conclusions Gastric emptying was faster in parturient women who undergo epidural analgesia than those who not. Pregnant women can safely eat small amounts of semi-solid food to meet their energy needs during delivery.

show abstract

The efficacy and safety of remifentanil patient-controlled versus epidural analgesia in labor: A meta-analysis and systematic review

Lei

et al. 2022

PLoS ONE

View full text Add to dashboard Cite

Background Remifentanil patient-controlled analgesia (rPCA) and epidural analgesia (EA) has been used for pain relief in labor. We aimed to evaluate the efficacy and safety of rPCA versus EA in labor, to provide evidence support for clinical analgesia and pain care. Methods We searched PubMed, EMBASE, ScienceDirect, Cochrane Library, China National Knowledge Infrastructure (CNKI), Wanfang and Weipu databases for RCTs comparing rPCA and EA in labor until February 15, 2022. Two researchers independently screened literature and extracted data. RevMan 5.3 software was used for data analysis. Results A total of 10 RCTs involving 3086 parturients were enrolled, 1549 parturients received rPCA and 1537 received EA. Meta-analysis indicated that the incidence of intrapartum maternal fever within 1 hour of labor analgesia (OR = 0.43, 95%CI: 0.30~0.62), after 1 hour of labor analgesia (OR = 0.42, 95%CI: 0.20~0.90) in the rPCA was significantly less than that of EA (all P<0.05). The incidence of respiratory depression (OR = 3.56, 95%CI: 2.45~5.16, P<0.001) in the rPCA was significantly higher than that of EA. There were no significant differences in the incidence of Apgar scores<7 at 5 minutes (OR = 1.18, 95%CI: 0.71~1.96, P = 0.53), the patients’ satisfaction of pain relief during labor analgesia (SMD = 0.03, 95%CI: -0.40~0.46, P = 0.90) between rPCA and EA (all P>0.05). Conclusion rPCA can be an optional alternative to EA with similar pain relief and less risk of intrapartum maternal fever. However, rPCA was associated with increased risk of respiratory depression. Future studies with rigorous design and larger sample size are needed to provide more reliable evidences for clinical rPCA and EA use.

show abstract

Labor analgesia: Comparison of epidural patient-controlled analgesia and intravenous patient-controlled analgesia

Cited by 5 publications

References 48 publications

The Effects of Different Puncture Points on Labor Analgesia Onset: Study Protocol for a Randomized Controlled Trial

The Effects of Different Puncture Points on Labor Analgesia Onset: Study Protocol for a Randomized Controlled Trial

Effects of epidural analgesia on gastric emptying in parturients monitored by ultrasound

The efficacy and safety of remifentanil patient-controlled versus epidural analgesia in labor: A meta-analysis and systematic review

Contact Info

Product

Resources

About