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Efficacy of patient-controlled epidural analgesia after initiation with epidural or combined spinal-epidural analgesia.
Int J Obstet Anesth. 2007 Jul; 16(3):226-30.IJ

Abstract

BACKGROUND

The aim of the present study was to compare the efficacy of patient-controlled epidural analgesia after initiation with either epidural or combined spinal-epidural analgesia.

METHODS

Forty ASA I parturients at 37-42 weeks' gestation and cervical dilatation <6 cm were randomly allocated to receive either epidural analgesia (group EA) or combined spinal-epidural analgesia (group CSEA). Analgesia was initiated with a 7-mL epidural bolus 0.1% bupivacaine containing fentanyl 50 mug (group EA, n=20) or with intrathecal fentanyl 20 mug (group CSEA, n=20). In both groups, analgesia was provided by a 5-mL bolus on demand via PCEA with a 10-min lock-out interval and a 15-mL/h limit.

RESULTS

No significant differences were observed in the rate of cervical dilatation, delivery type or duration of delivery between the groups. The time to first analgesic demand was shorter in the CSEA than in the EA group. Total bupivacaine dose was comparable in both groups, but total fentanyl dose in group CSEA was significantly lower than that of group EA because of the initial dose used for the induction of EA and CSEA. The incidence of pruritus in group CSEA was significantly higher than in group EA.

CONCLUSION

Both regional analgesia techniques followed by demand-only PCEA provided efficient pain relief for labor without changing the duration of labor or rate of cesarean section.

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Authors+Show Affiliations

Sezer OA
Department of Anesthesiology and Reanimation, Gazi University Faculty of Medicine, Besveler, Ankara, Turkey.
Gunaydin B
No affiliation info available

MeSH

AdultAnalgesia, EpiduralAnalgesia, ObstetricalAnalgesia, Patient-ControlledAnalgesicsAnesthesia, SpinalAnesthetics, LocalApgar ScoreBlood PressureFemaleHeart RateHumansInfant, NewbornLabor Stage, FirstLabor Stage, SecondLidocainePain MeasurementPatient SatisfactionPregnancyTreatment Outcome

Pub Type(s)

Journal Article
Randomized Controlled Trial

Language

eng

PubMed ID

17509869

Citation

Sezer, O A., and B Gunaydin. "Efficacy of Patient-controlled Epidural Analgesia After Initiation With Epidural or Combined Spinal-epidural Analgesia." International Journal of Obstetric Anesthesia, vol. 16, no. 3, 2007, pp. 226-30.
Sezer OA, Gunaydin B. Efficacy of patient-controlled epidural analgesia after initiation with epidural or combined spinal-epidural analgesia. Int J Obstet Anesth. 2007;16(3):226-30.
Sezer, O. A., & Gunaydin, B. (2007). Efficacy of patient-controlled epidural analgesia after initiation with epidural or combined spinal-epidural analgesia. International Journal of Obstetric Anesthesia, 16(3), 226-30.
Sezer OA, Gunaydin B. Efficacy of Patient-controlled Epidural Analgesia After Initiation With Epidural or Combined Spinal-epidural Analgesia. Int J Obstet Anesth. 2007;16(3):226-30. PubMed PMID: 17509869.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Efficacy of patient-controlled epidural analgesia after initiation with epidural or combined spinal-epidural analgesia. AU - Sezer,O A, AU - Gunaydin,B, Y1 - 2007/05/16/ PY - 2006/11/26/received PY - 2007/02/01/accepted PY - 2007/5/19/pubmed PY - 2007/8/29/medline PY - 2007/5/19/entrez SP - 226 EP - 30 JF - International journal of obstetric anesthesia JO - Int J Obstet Anesth VL - 16 IS - 3 N2 - BACKGROUND: The aim of the present study was to compare the efficacy of patient-controlled epidural analgesia after initiation with either epidural or combined spinal-epidural analgesia. METHODS: Forty ASA I parturients at 37-42 weeks' gestation and cervical dilatation <6 cm were randomly allocated to receive either epidural analgesia (group EA) or combined spinal-epidural analgesia (group CSEA). Analgesia was initiated with a 7-mL epidural bolus 0.1% bupivacaine containing fentanyl 50 mug (group EA, n=20) or with intrathecal fentanyl 20 mug (group CSEA, n=20). In both groups, analgesia was provided by a 5-mL bolus on demand via PCEA with a 10-min lock-out interval and a 15-mL/h limit. RESULTS: No significant differences were observed in the rate of cervical dilatation, delivery type or duration of delivery between the groups. The time to first analgesic demand was shorter in the CSEA than in the EA group. Total bupivacaine dose was comparable in both groups, but total fentanyl dose in group CSEA was significantly lower than that of group EA because of the initial dose used for the induction of EA and CSEA. The incidence of pruritus in group CSEA was significantly higher than in group EA. CONCLUSION: Both regional analgesia techniques followed by demand-only PCEA provided efficient pain relief for labor without changing the duration of labor or rate of cesarean section. SN - 0959-289X UR - https://www.unboundmedicine.com/medline/citation/17509869/Efficacy_of_patient_controlled_epidural_analgesia_after_initiation_with_epidural_or_combined_spinal_epidural_analgesia_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0959-289X(07)00046-5 DB - PRIME DP - Unbound Medicine ER -