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A Journal on Anesthesiology, Resuscitation, Analgesia and Intensive Care
ORIGINAL ARTICLES ANESTESIOLOGY
Minerva Anestesiologica 2002 March;68(3):83-7
Epidural analgesia during labor: intermittent bolus or patient controlled administration?
De Eccher L., Martino C. *, Bacchilega I. *, Rainaldi M. P., Baroncini S.
Policlinico S. Orsola Malpighi - Bologna Dipartimento di Anestesia e Rianimazione Terapia Intensiva e Antalgica - U.O. Anestesia e Rianimazione Baroncini Azienda Ospedaliera di Bologna - Bologna Università degli Studi - Bologna
*Scuola di Specialità in Anestesia e Rianimazione Policlinico S. Orsola Malpighi - Bologna
Background. The aim of the study was to compare efficacy and side effects produced by two techniques of epidural analgesia during labor: intermittent bolus and patient-controlled epidural analgesia.
Methods. Eighty parturients were enrolled in this study: forty received intermittent bolus analgesia (first bolus: 20 mg of ropivacaine 0.1% + 10 gamma of sufentanil, next bolus: 10 mg of ropivacaine 0.1% during the first 4 hours, and then 10 mg of ropivacaine 0.1% + 2.5 gamma of sufentanil each time they complained of pain), and forty parturients received PCEA (starting with a bolus of 20 mg ropivacaine 0.1% + 10 gamma sufentanil, followed by administration with a pump programmed to deliver a continuous background infusion of ropivacaine 0,1% + 0.25 gamma/ml of sufentanil at 5 ml/h and 5 ml patient-triggered boluses with a 15 min lock-out interval; insufficient analgesia was treated by extra boluses of the same ropivacaine solution). In each group the efficacy of the analgesia (verbal numerical pain scores, amount of local anesthetics consumption), labor duration, side effects and patient satisfaction have been studied.
Results. There were no differences between the two different epidural techniques.
Conclusions. This regimen of PCEA proves a viable and safe alternative for epidural analgesia during labor.