title: A comparative study of patient controlled epidural analgesia (PCEA) and continuous infusion epidural analgesia (CIEA) during labour.
abstract: In a randomised, single-blinded, placebo-controlled study, 27 parturients in labour receiving epidural 0.125 per cent bupivacaine, were assessed to evaluate the efficacy of patient-controlled epidural analgesia (PCEA) compared with continuous infusion epidural analgesia (CIEA). Group A (n = 14) received a background infusion of 4 ml.hr-1 0.125 per cent bupivacaine, with further 4 ml aliquots, self-administered, as required (up to 16 ml.hr-1). Group B (n = 11) received a continuous infusion of 12 ml.hr-1 through the same PCA apparatus, but with the demand-button deactivated. Both groups were similar in respect to age, height, weight, duration and outcome of labour, birthweight and neonatal Apgar scores. Patients in Group A (PCEA) received significantly less local anaesthetic than those in Group B (11.2 vs 15.2 mg.hr-1). Pain relief was similar in both groups. Patients expressed overall satisfaction with PCEA, appreciating control over their own pain relief and less reliance on medical staff. PCEA is a safe, effective means of providing optimal analgesia during labour, with minimal local anaesthetic requirement.
authors.affiliation: Department of Anaesthesia, University of British Columbia, Vancouver.
authors.forename: D R
authors.initials: DR
authors.lastname: Gambling
authors.forename: P
authors.initials: P
authors.lastname: Yu
authors.forename: C
authors.initials: C
authors.lastname: Cole
authors.forename: G H
authors.initials: GH
authors.lastname: McMorland
authors.forename: L
authors.initials: L
authors.lastname: Palmer
mesh_terms: D000328:Adult; D000767:Anesthesia, Epidural / Q000379:methods*; D000773:Anesthesia, Obstetrical / Q000379:methods*; D002045:Bupivacaine / Q000008:administration & dosage; D002986:Clinical Trials as Topic; D005260:Female; D006801:Humans; D007743:Labor, Obstetric; D011247:Pregnancy; D011897:Random Allocation; D012646:Self Administration
chemical_list: D002045:Bupivacaine