title: Double-blind evaluation of patient-controlled epidural analgesia during labor.
abstract: A double-blind randomized study was designed to compare the efficacy of patient-controlled epidural analgesia (PCEA) with continuous epidural analgesia (CEA) with regards to patient satisfaction with analgesia, analgesic efficacy, and local anesthetic usage. After establishing effective epidural analgesia with 8 ml of 0.25% bupivacaine, 39 parturients were randomized to 1 of 2 groups. The CEA group received a continuous infusion of 12 ml/h of 0.125% bupivacaine. The PCEA group received a background infusion of 4 ml/h of 0.125% bupivacaine and were able to self-administer additional boluses of 3 ml of 0.25% bupivacaine every 10 min up to 15 ml/h. In both groups, when patients complained of inadequate analgesia, supplemental doses of 5 ml of 0.25% bupivacaine were administered by a physician. The 2 groups were similar in age, height, weight, gravidity, labor duration, motor block, sensory block, and infant Apgar scores. The 2 groups also did not differ significantly in terms of patient satisfaction, pain assessment, or total drug usage. However, the PCEA group required significantly fewer supplemental doses (15%) compared with the CEA group (40%). The decreased need for supplemental doses in the PCEA group may suggest a potential advantage in consistency of analgesia and possibly decreased man-power needs.
authors.affiliation: Dept. of Anesthesiology, University of California Medical Center, 225 Dickinson Street, San Diego, California 92103, USA.
authors.forename: R J
authors.initials: RJ
authors.lastname: Fontenot
authors.forename: R L
authors.initials: RL
authors.lastname: Price
authors.forename: A
authors.initials: A
authors.lastname: Henry
authors.forename: L S
authors.initials: LS
authors.lastname: Reisner
authors.forename: M B
authors.initials: MB
authors.lastname: Weinger