Top-ups versus infusions and patient-controlled epidural analgesia (PCEA)

  • David R. Gambling


The future of PCEA is in the hands of clinicians around the world. It remains to be seen if the technique becomes universally employed. This may well depend on economic (price of the PCA pump), technical (development of simple, portable, PCA devices), social (consumer demand) and scientific factors (unrealised advantages or disadvantages of PCEA determined by large, randomised clinical trials). Theoretically, it is hard to argue with the PCEA concept since it restores an element of control to the parturient, and allows instantaneous epidural dosing. Despite earlier concerns,42 the safety of PCEA over the past decade has been shown to be comparable to other available techniques and the advantages of PCEA make it a compelling first option for epidural drug delivery in the new millennium.


Epidural Analgesia Epidural Catheter Motor Block Epidural Infusion Obstetric Anesthesia 
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© Springer-Verlag London 2000

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  • David R. Gambling

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