Canadian journal of anaesthesia = Journal canadien d'anesthésie
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Randomized Controlled Trial Comparative Study Clinical Trial
A comparative study of continuous and intermittent epidural analgesia for labour and delivery.
This study compares a continuous infusion technique with intermittent "top-up" doses using 0.25 per cent bupivacaine for epidural analgesia for labour and delivery in healthy primiparous patients. Sixty women were randomized into two groups, A (continuous) and B (intermittent). Twenty-eight patients in Group A and 29 in Group B completed the study. ⋯ More women in Group A required outlet forceps (p less than 0.05) whereas mid-forceps and Caesarean section rates were similar in the two groups. Fewer mothers in the infusion group had spontaneous vaginal delivery. We conclude that infusion techniques are as effective as intermittent top-up epidurals and are well received by mothers in labour.
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Randomized Controlled Trial Comparative Study Clinical Trial
A comparative study of patient controlled epidural analgesia (PCEA) and continuous infusion epidural analgesia (CIEA) during labour.
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. ⋯ 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.