Labor pain relief using bupivacaine and sufentanil: patient controlled epidural analgesia versus intermittent injections.
OBJECTIVE
To determine whether the use of patient-controlled epidural analgesia (PCEA) versus intermittent injections (CIT) resulted in local anesthetic dose reduction.


METHODS
PCEA and CIT using a mixture of 0.125% bupivacaine with sufentanil 1 or 0.75 microgram/ml were compared in 60 and 195 parturients, respectively. Assessments included pain scores, local anesthetic consumption, degree of motor blockade, type of delivery and neonatal outcome. Statistical analysis was done using Student's t test and Chi-squares.


RESULTS
PCEA and CIT provided effective analgesia during labor and delivery. A higher dose of opioid significantly reduced the use of local anesthetic solution in PCEA-patients. There was no difference in motor blockade, type of delivery and neonatal outcome.


CONCLUSIONS
Patient-controlled epidural analgesia is an effective, safe and acceptable alternative to conventional intermittent epidural injections for pain relief during labor and delivery.
Vandermeulen
E P
EP
Department of Anesthesiology, Universitair Ziekenhuis Gasthuisberg, Leuven, Belgium.
Van Aken
H
H
Vertommen
J D
JD
D000328:Adult; D015360:Analgesia, Epidural / Q000592:standards*; D016362:Analgesia, Obstetrical / Q000592:standards*; D016058:Analgesia, Patient-Controlled / Q000592:standards*; D000701:Analgesics, Opioid / Q000008:administration & dosage / Q000592:standards / Q000627:therapeutic use; D000779:Anesthetics, Local / Q000008:administration & dosage / Q000592:standards / Q000627:therapeutic use; D002045:Bupivacaine / Q000008:administration & dosage / Q000592:standards / Q000627:therapeutic use; D004338:Drug Combinations; D004837:Epinephrine / Q000008:administration & dosage / Q000592:standards / Q000627:therapeutic use; D005260:Female; D006801:Humans; D007267:Injections / Q000592:standards; D007743:Labor, Obstetric / Q000187:drug effects / Q000502:physiology*; D010146:Pain / Q000188:drug therapy* / Q000503:physiopathology; D011247:Pregnancy; D011256:Pregnancy Outcome; D017409:Sufentanil / Q000008:administration & dosage / Q000592:standards / Q000627:therapeutic use
D000701:Analgesics, Opioid; D000779:Anesthetics, Local; D004338:Drug Combinations; D017409:Sufentanil; D002045:Bupivacaine; D004837:Epinephrine