Iraqi Postgraduate Medical Journal

Current Issue

By Issue

By Subject

Keyword Index

Author Index

Indexing Databases XML

About Journal

Aims and Scope

Editorial Board

Advisory Board

Editorial Staff

Publication Ethics

Indexing and Abstracting

News

Painless Labor: Comparison between Patient Controlled Epidural Analgesia and Continuous Epidural Analgesia

Iraqi Postgraduate Medical Journal, 2021, Volume 20, Issue 4, Pages 338-343
10.52573/ipmj.1970.170478

Abstract

ABSTRACT:
BACKGROUND:                                                                                     
 Patient-controlled epidural analgesia has been considered as superior to continuous epidural infusion for labor pain control.
AIM OF STUDY:
The aim   was to establish     the efficacy of Patient Controlled Epidural Analgesia for control of labor pain   and improve the quality of analgesia.
 METHODS:
This study was done on 20 patients; they were given bolus of 10 ml of   0.125% bupivacaine +2 Mg /ml fentanyl then divided into: Group A can put the device to deliver 5ml of 0.125% bupivacaine +2Mg /ml fentanyl with lockout interval 20 min; Group B had the PCA system to deliver continuous infusion of 10 ml /hr. In each group if patient still suffer from pain, patients were received additional dose of 5ml of same solution.
RESULTS:          
Data showed that total amount of LA in group A was lower than group B    (18.44ml versus 20ml in 1st hr., 2.5ml versus 10ml in 2nd hr.). Regarding additional     boluses, CIEA group needed more extra boluses of LA at 20, and 60 mints (5.0ml versus 1.0ml, 4.0 ml versus 0.5ml).  CONCLUSION:
 The use of PCEA associated with lower doses of local anesthetic with   better quality of analgesia and maternal satisfaction.
 
 
Keywords:

  1. Biere.H.Y. A.M., Robert . Med et al. Acute pain and the obstetric patient : recent developments in analgesia for labor and delivery. International Anesthesiology Clinics2016;35:90-150.
  2. Bonica JJ. Peripheral mechanisms and pathways of parturition pain. British Journal of Anaesthesia2015; 51 (Supplement): S3-S9.
  3. Brown-ridge P. The nature and consequences childbirth pain. European Journal of Obstetrics, Gynecology and reproductive Biology 2010;59:S9-S15.
  4. Morgan GE,Mikhail MS:Clinical Anesthesiology.5TH EDITION.2013;7:847.
  5. RG Wheatley, SA Schug, D Watson .Safety and efficacy of postoperative epidural analgesia, Br J Anaesth, 2001;87: 47-61.
  6. Karanikolas M, Aretha D, Kiekkas P, Monantera G, Tsolakis I, Filos KS (October 2010). "Case report. Intravenous fentanyl patient-controlled analgesia for perioperative treatment of neuropathic/ischaemic pain in haemodialysis patients: a case series". J Clin Pharm Ther.2010;35 : 603–8. doi:10.1111/j.1365-2710.2009.01114.x. PMID 20831684.
  7. Dragon A, Goldstein I (1967).  Variables of patient-controlled analgesia. Journal of the American Dental Association. 2017; 75 : 1176–81.

 

 

  1. Morgan GE,Mikhail MS. Clinical Anesthesiology.5TH EDITION.2013;5: 851.
  2. Glosten B. Epidural and spinal analgesia/anesthesia. In: Chestnut DH, ed. Obstetric Anesthesia: Principles and practice, 2nd edition. St Louis: Mosby, 1999; 23:360-86.

10. Sheng-Huan Chen, MD; Shiue-Chin Liou, MD; Chao-Tsen Hung, MD;et al. Comparison of Patient-controlled Epidural Analgesia and Continuous Epidural Infusion for Labor Analgesia. Chang Gung Med J 2006; 29:576-82.

11. M. van der Vyver1, S. Halpern2* and G. Joseph. Patient-controlled epidural analgesia versus continuous infusion for labour analgesia: a meta-analysis. BrJ Anaesth 2016; 89: 459-65.

12. N.BROGLY, R.SCHIRALDI, B.VAZQUEZ et al. A randomized control trial of patient controlled epidural analgesia (PCEA) with and without background infusion using levobupivacaine and fentanyl. Minerva Anestesiol 2011; 77:1149_54.

13. Sumaiah Tahseen S, Mohammed K, Sahajananda H, et al.Comparison of patient controlled epidural analgesia with continuous epidural infusion for labour analgesia. J. Evolution Med. Dent. Sci. 2016;5:3862-67, DOI: 10.14260/jemds/2016/884

14. Y.LimA.T, H.SiaC, Ocampo.Automated regular boluses for epidural      analgesia: a comparison with continuous infusion. International Journal of Obstetric Anesthesia (2005); 14(4): 305-309. https://doi.org/10.1016/j.ijoa.2005.05.004

15. N.BROGLY, R.SCHIRALDI, B.VAZQUEZ et al. A randomized control trial of patient controlled epidural analgesia (PCEA) with and without background infusion using levobupivacaine and fentanyl. Minerva Anestesiol 2016; 77:1149-54.

  • Article View: 49
  • PDF Download: 38