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Comparison of three modes of patient-controlled epidural analgesia during labour

Published online by Cambridge University Press:  13 April 2005

S. M. Siddik-Sayyid ,
M. T. Aouad ,
M. I. Jalbout ,
M. I. Zalaket ,
M.-R. A. Mouallem ,
F. M. Massouh ,
L. B. Rizk ,
H. H. Maarouf  and
A. S. Baraka
S. M. Siddik-Sayyid
Affiliation:
American University of Beirut, Department of Anesthesiology, Beirut, Lebanon
M. T. Aouad
Affiliation:
American University of Beirut, Department of Anesthesiology, Beirut, Lebanon
M. I. Jalbout
Affiliation:
American University of Beirut, Department of Anesthesiology, Beirut, Lebanon
M. I. Zalaket
Affiliation:
American University of Beirut, Department of Anesthesiology, Beirut, Lebanon
M.-R. A. Mouallem
Affiliation:
American University of Beirut, Department of Anesthesiology, Beirut, Lebanon
F. M. Massouh
Affiliation:
American University of Beirut, Department of Anesthesiology, Beirut, Lebanon
L. B. Rizk
Affiliation:
American University of Beirut, Department of Anesthesiology, Beirut, Lebanon
H. H. Maarouf
Affiliation:
American University of Beirut, Department of Anesthesiology, Beirut, Lebanon
A. S. Baraka
Affiliation:
American University of Beirut, Department of Anesthesiology, Beirut, Lebanon
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Extract

Summary

Background and objectives: This study compares three modes of patient-controlled epidural analgesia in parturients during labour.

Methods: Eighty-four women were randomized to one of three groups. The epidural solution used in all the three groups was 0.1% bupivacaine with fentanyl 2 μg mL−1. Patients were able to self administer a demand dose of 3 mL with a lockout interval of 6 min in Group A, 6 mL with a lockout interval of 12 min in Group B and 9 mL with lockout interval of 18 min in Group C. All patients received a background infusion at a rate of 6 mL h−1. Visual analogue pain scores, pinprick analgesia and motor block were assessed hourly by a blinded observer. The physician-administered supplementation and the cumulative dose of bupivacaine were also compared between the three groups.

Results: Pain scores, sensory level and motor block were not different among the study groups. Patients' satisfaction was rated good to excellent with no difference among groups. The cumulative dose of bupivacaine was not significantly different. However, there was a trend towards a decreased need for rescue analgesia in Group C. Within each group, the physician-administered supplementations were significantly higher during the second stage of labour than during the first stage (P < 0.05).

Conclusion: The three modes of patient-controlled epidural analgesia supplemented by a background infusion of 6 mL h−1 were equally effective for labour analgesia with a trend for decreased rescue analgesia in the group with a larger bolus dose and a longer lockout interval.

Keywords

ANAESTHESIA, obstetricalANALGESIA, obstetrical, patient-controlled, epiduralANAESTHETICS, LOCAL, bupivacaineANALGESICS, OPIOID, fentanyl
Type
Original Article
Information
European Journal of Anaesthesiology , Volume 22 , Issue 1 , January 2005 , pp. 30 - 34
Copyright
© 2005 European Society of Anaesthesiology

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