Canadian Journal of Anaesthesia

, Volume 35, Issue 3, pp 249–254

A comparative study of patient controlled epidural analgesia (PCEA) and continuous infusion epidural analgesia (CIEA) during labour

  • David R. Gambling
  • Patrick Yu Colm Cole
  • Graham H. McMorland
  • Lynne Palmer
Article

Abstract

In a randomised, single-blinded, placebo-controlled study, 27 parturients in labour receiving epidural 0.125 per cent bupivacaine, were assessed to evaluate the efficacy of patientcontrolled epidural analgesia (PCEA) compared with continuous infusion epidural analgesia (CIEA). Group A (n = 14) received a background infusion of 4ml hr-1 0.125 per cent bupivacaine, with further 4 ml aliquots, self-administered, as required (up to 16 mi.hr-1). Group B (n = 11) received a continuous infusion of 12 ml.hr-1 through the same PCA apparatus, but with the demand-button deactivated. Both groups were similar in respect to age, height, weight, duration and outcome of labour, birthweight and neonatal Apgar scores. Patients in Group A (PCEA) received significantly less local anaesthetic than those in Group B (112 vs 15,2 mg.hr-1). Pain relief was similar in both groups. Patients expressed overall satisfaction with PCEA, appreciating control over their own pain relief and less reliance on medical staff. PCEA is a safe, effective means of providing optimal analgesia during labour, with minimal local anaesthetic requirement.

Key words

Anaesthesia obstetric Anaesthetic techniques epidural Anaesthetics local bupivacaine Equipment patient-controlled analgesia 

Résumé

Dans une étude randomisée, à simple insu, et contrôlée par du placebo, 27 parturientes en travail ayant une épidurale 0.125 pour cent de bupivacaïne, étaient étudiées afin ďévaluer ľefficacité de ľanalgésie épidurale contrôlée par le patient (PCEA) comparéà ľanalgésie épidurale par perfusion continue (CIEA) Le groupe A (n = 14) a reçu une perfusion continue de 4 ml.hr-1 de 0.125 pour cent de bupivacaine avec des doses de “rajout” de 4 ml que les patientes s’administraient selon le besoin (jusqu’à 16ml.hr-1). Le groupe B (n = 11) a reçu une perfusion continue de 12 ml.hr-1 travers le même appareil PCA sans que la patiente soit capable de s’administrer elle-même sur demande ľanalgésique. Les deux groupes étaient similaires par rapport à ľâge, la taille, le poids, la durée et ľissue du travail, le poids du bébé et le score néonatal ďApgar. Les patients du groupe A (PCEA) ont reçu significativement moins ďanesthêsique local que celles du groupe B (11.2 versus 15.2 mg.hr-1). Le soulagement de la douleur était similaire dans les deux groupes. Les patientes ont exprimé leur satisfaction générale avec la PCEA appréciant le contrôle personnel qu’elles avaient sur leur douleur ce qui leur procurait moins de dépendance sur ľéquipe médicale. La PCEA est un moyen sécuritaire efficace fournissant une analgésie optimale durant le travail avec un minimum ďagents anesthésiques locaux.

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Copyright information

© Canadian Anesthesiologists 1988

Authors and Affiliations

  • David R. Gambling
    • 1
  • Patrick Yu Colm Cole
    • 1
  • Graham H. McMorland
    • 1
  • Lynne Palmer
    • 1
  1. 1.Department of AnaesthesiaUniversity of British Columbia and Grace HospitalVancouverBritish Columbia

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