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

Singh, Saroj; Singh, Ankita; Srivastava, Uma

doi:10.1007/s13224-011-0059-y

Cited by 10 publications

(5 citation statements)

References 9 publications

(14 reference statements)

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“…There was a higher maternal satisfaction score in PCEA group than intermittent bolus group this is in contrast to the study done by Singh et al, 9 where they found similar levels of maternal satisfaction in both the groups. Whereas Roofthooft et al,8 in their study observed that patient satisfaction scores were same in both the groups.…”

Section: Discussioncontrasting

confidence: 97%

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A randomized comparative study of patient-controlled epidural analgesia with manual standard intermittent bolus for labor analgesia

Manish Banjare,

Aditi Kaushal,

Deepali Valecha

et al. 2023

Asian J Med Sci

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Background: Patient-controlled epidural analgesia (PCEA) pump has proven to reduce the incidence of unscheduled clinician interventions and total dose of local anesthetic administered for labor pain. Aims and Objectives: The aim of the study was to compare the quality of analgesia, maternal satisfaction, amount of rescue analgesia needed, and neonatal outcome between clinician delivered manual bolus doses and PCEA pumps for epidural labor analgesia. Materials and Methods: 60 parturients of the American Society of Anesthesiologists II scheduled for normal vaginal delivery were randomly divided into two groups, Group A (PCEA) and Group B (Manual bolus). Both groups received an initial epidural bolus of 10 mL of 0.125% Inj. Bupivacaine+20 mcg injection fentanyl. Group A (PCEA) patients received a basal infusion of 5 mL/h with self-administered bolus of 2 mL with a lockout interval of 15 min. Group B patients were provided with a bolus of 10 mL of the same solution manually after every hour. Patients of both groups were given manual rescue boluses for distressing pain (visual analog scale [VAS] >5). Results: Mean VAS score in Group A was 2.97±0.73; and in Group B, it was 3.03±0.56 (P>0.05). Total bupivacaine use and mean duration of second stage of labor in both groups was found comparable. Mean top-up requirement of local anesthetics was significantly high in Group B. Maternal satisfaction was also higher in PCEA group. Conclusion: As PCEA pump provides continuous infusion of local anesthetics, there was lesser requirement of top ups of bupivacaine and higher maternal satisfaction score in PCEA group than manual bolus group.

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Section: Discussioncontrasting

confidence: 97%

“…(P=0.079). 7 Our findings are also corroborated with the study done by Singh et al, 9 where 12 where the percentage of women requiring rescue boluses was significantly higher in the PIEB+PCEA group.…”

Section: Discussionsupporting

confidence: 90%

A randomized comparative study of patient-controlled epidural analgesia with manual standard intermittent bolus for labor analgesia

Manish Banjare,

Aditi Kaushal,

Deepali Valecha

et al. 2023

Asian J Med Sci

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“…In this study, good analgesic effects have been achieved in the later stage of labor in both groups, so there was less need for remedial analgesia. In the study of Sng et al 12 , 0.2% ropivacaine was able to bring good analgesic effects and no adverse reactions, in line with the results of this study. In the present study, the remedial effect of 0.2% ropivacaine was better, most of the parturients only needed one remedy, and none of them was withdrawn from the study due to remedy failure.…”

Section: Discussionsupporting

confidence: 91%

Effects of 0.15% ropivacaine alone and combination with sufentanil on epidural labor analgesia and adverse reactions

Zhong,

Wang,

Wang

et al. 2023

Afr H. Sci.

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Objective: The aim of this study was to compare the impacts of 0.15% ropivacaine alone and 0.15% ropivacaine combined withsufentanil on epidural labor analgesia. Methods: A total of 297 eligible primiparae were randomly divided into group A (n=149, 0.15% ropivacaine + sufentanil) andgroup B (n=148, 0.15% ropivacaine). Visual analogue scale (VAS) scores prior to analgesia and 20 min following epidural medication,the maximum VAS score during labor, dosage of analgesic drugs, modified Bromage score, satisfaction degree, laborduration, delivery mode, 1-min and 5-min Apgar scores of newborns, adverse reactions during analgesia, and fever during laborwere recorded. Results: Group A and B had similar VAS scores 20 min following epidural medication and maximum score during labor(P>0.05), which significantly fell compared with those before labor analgesia (P<0.05). The occurrence rates of nausea andvomiting were of significant difference (P<0.05). Conclusion: 0.15% ropivacaine alone achieves a comparable epidural labor analgesia effect to that of 0.15% ropivacaine + 0.05μg/mL sufentanil on primiparae. Keywords: Ropivacaine; sufentanil; epidural labor analgesia; adverse reaction.

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“…Se estima que los pacientes con dolor severo (como es el caso de la población obstétrica presentada en este estudio) requieren una disminución de 4 puntos en la EVA para considerar que se obtuvo una mejoría significativa del dolor [11]. Los hallazgos de este estudio muestran una disminución del dolor en la EVA mayor a 4 puntos a los 30 minutos del inicio de la analgesia peridural, siendo este significativo y dejando a las pacientes en un rango de dolor leve, que se correlaciona con los datos encontrados en la literatura [12][13][14].…”

Section: Discussionunclassified

“…Respecto a los resultados de satisfacción global con la analgesia peridural, los hallazgos se correlacionan con lo encontrado en la literatura [3,4,6,12,13]. A pesar de este hallazgo global de excelente satisfacción (mediana de 9/10), pensamos que se debe tomar con precaución, ya que esta evaluación se realizó en el periodo posparto, momento en el cual el resultado más importante para la madre es un neonato sano.…”

Section: Discussionunclassified

Evaluación clínica del protocolo de manejo de la analgesia peridural obstétrica en el Hospital Universitario San Ignacio

et al. 2014

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Introducción: la mejor analgesia para el dolor del trabajo de parto es la neuroaxial. Existe evidencia para el uso de concentraciones menores de anestésico local combinado con opioides, vía peridural, a las utilizadas en el Hospital Universitario San Ignacio. Por esta razón se quiso evaluar el protocolo de analgesia obstétrica ofrecida actualmente en el hospital. Métodos: se realizó un estudio observacional en mujeres en trabajo de parto, a las que se les colocó analgesia peridural en bolos según requerimiento, utilizando una mezcla de 8-10 ml de bupivacaína al 0,1 % y fentanilo 2 μg/cm3. El dolor se evaluó con la escala visual análoga a los 30, 120, 240 min y primera hora posparto.Resultados: el dolor a los 30 min de iniciada la analgesia disminuyó de severo a leve, y en las siguientes mediciones el dolor se encontró en un rango de moderado o severo. En cuanto a bloqueo motor e hipotensión a los 30 min, los hallazgos son superiores a los reportados en la literatura. Respecto a efectos secundarios, vía del parto, resultados neonatales y satisfacción materna, los resultados son similares a los encontrados en la literatura.Conclusiones: la mezcla analgésica utilizada en el hospital controla adecuadamente el dolor después de la primera dosis; sin embargo, falla en el mantenimiento posterior de una analgesia óptima, por lo que es necesario optimizar el proceso de seguimiento analgésico.

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

Abstract: 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.

Cited by 10 publications

References 9 publications

A randomized comparative study of patient-controlled epidural analgesia with manual standard intermittent bolus for labor analgesia

A randomized comparative study of patient-controlled epidural analgesia with manual standard intermittent bolus for labor analgesia

Effects of 0.15% ropivacaine alone and combination with sufentanil on epidural labor analgesia and adverse reactions

Evaluación clínica del protocolo de manejo de la analgesia peridural obstétrica en el Hospital Universitario San Ignacio

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