A randomized comparative study of patient-controlled epidural analgesia with manual standard intermittent bolus for labor analgesia
Background: Patient-controlled epidural analgesia (PCEA) pump has proven to reduce the incidence of unscheduled clinician interventions and total dose of local anesthetic administered for labor pain. Aims and Objectives: The aim of the study was to compare the quality of analgesia, maternal satis...
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| Format: | Article |
| Language: | English |
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Manipal College of Medical Sciences, Pokhara
2023-09-01
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| Series: | Asian Journal of Medical Sciences |
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| Online Access: | https://www.nepjol.info/index.php/AJMS/article/view/54656 |
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| author | Manish Banjare Aditi Kaushal Deepali Valecha Nandini Bhatt K. K. Arora |
| author_facet | Manish Banjare Aditi Kaushal Deepali Valecha Nandini Bhatt K. K. Arora |
| author_sort | Manish Banjare |
| collection | DOAJ |
| description | Background: Patient-controlled epidural analgesia (PCEA) pump has proven to reduce the incidence of unscheduled clinician interventions and total dose of local anesthetic administered for labor pain.
Aims and Objectives: The aim of the study was to compare the quality of analgesia, maternal satisfaction, amount of rescue analgesia needed, and neonatal outcome between clinician delivered manual bolus doses and PCEA pumps for epidural labor analgesia.
Materials and Methods: 60 parturients of the American Society of Anesthesiologists II scheduled for normal vaginal delivery were randomly divided into two groups, Group A (PCEA) and Group B (Manual bolus). Both groups received an initial epidural bolus of 10 mL of 0.125% Inj. Bupivacaine+20 mcg injection fentanyl. Group A (PCEA) patients received a basal infusion of 5 mL/h with self-administered bolus of 2 mL with a lockout interval of 15 min. Group B patients were provided with a bolus of 10 mL of the same solution manually after every hour. Patients of both groups were given manual rescue boluses for distressing pain (visual analog scale [VAS] >5).
Results: Mean VAS score in Group A was 2.97±0.73; and in Group B, it was 3.03±0.56 (P>0.05). Total bupivacaine use and mean duration of second stage of labor in both groups was found comparable. Mean top-up requirement of local anesthetics was significantly high in Group B. Maternal satisfaction was also higher in PCEA group.
Conclusion: As PCEA pump provides continuous infusion of local anesthetics, there was lesser requirement of top ups of bupivacaine and higher maternal satisfaction score in PCEA group than manual bolus group. |
| first_indexed | 2024-03-12T11:05:59Z |
| format | Article |
| id | doaj.art-e817587411e74fedbed8860a38e58772 |
| institution | Directory Open Access Journal |
| issn | 2467-9100 2091-0576 |
| language | English |
| last_indexed | 2024-03-12T11:05:59Z |
| publishDate | 2023-09-01 |
| publisher | Manipal College of Medical Sciences, Pokhara |
| record_format | Article |
| series | Asian Journal of Medical Sciences |
| spelling | doaj.art-e817587411e74fedbed8860a38e587722023-09-02T03:53:50ZengManipal College of Medical Sciences, PokharaAsian Journal of Medical Sciences2467-91002091-05762023-09-011496468https://doi.org/10.3126/ajms.v14i9.54656A randomized comparative study of patient-controlled epidural analgesia with manual standard intermittent bolus for labor analgesiaManish Banjare 0https://orcid.org/0000-0001-7695-5645Aditi Kaushal 1https://orcid.org/0000-0003-0123-4557Deepali Valecha 2https://orcid.org/0000-0002-7813-6720Nandini Bhatt 3https://orcid.org/0009-0006-3139-2192K. K. Arora 4https://orcid.org/0000-0002-7376-4322Professor, Department of Anaesthesiology, Mahatma Gandhi Medical College, Indore, Madhya Pradesh, India Postgraduate Resident, Department of Anaesthesiology, Mahatma Gandhi Medical College, Indore, Madhya Pradesh, India Assistant Professor, Department of Anaesthesiology, Mahatma Gandhi Medical College, Indore, Madhya Pradesh, India Senior Resident, Department of Anaesthesiology, Mahatma Gandhi Medical College, Indore, Madhya Pradesh, India Professor and Head, Department of Anaesthesiology, Mahatma Gandhi Medical College, Indore, Madhya Pradesh, India Background: Patient-controlled epidural analgesia (PCEA) pump has proven to reduce the incidence of unscheduled clinician interventions and total dose of local anesthetic administered for labor pain. Aims and Objectives: The aim of the study was to compare the quality of analgesia, maternal satisfaction, amount of rescue analgesia needed, and neonatal outcome between clinician delivered manual bolus doses and PCEA pumps for epidural labor analgesia. Materials and Methods: 60 parturients of the American Society of Anesthesiologists II scheduled for normal vaginal delivery were randomly divided into two groups, Group A (PCEA) and Group B (Manual bolus). Both groups received an initial epidural bolus of 10 mL of 0.125% Inj. Bupivacaine+20 mcg injection fentanyl. Group A (PCEA) patients received a basal infusion of 5 mL/h with self-administered bolus of 2 mL with a lockout interval of 15 min. Group B patients were provided with a bolus of 10 mL of the same solution manually after every hour. Patients of both groups were given manual rescue boluses for distressing pain (visual analog scale [VAS] >5). Results: Mean VAS score in Group A was 2.97±0.73; and in Group B, it was 3.03±0.56 (P>0.05). Total bupivacaine use and mean duration of second stage of labor in both groups was found comparable. Mean top-up requirement of local anesthetics was significantly high in Group B. Maternal satisfaction was also higher in PCEA group. Conclusion: As PCEA pump provides continuous infusion of local anesthetics, there was lesser requirement of top ups of bupivacaine and higher maternal satisfaction score in PCEA group than manual bolus group.https://www.nepjol.info/index.php/AJMS/article/view/54656labor analgesia; patient-controlled epidural analgesia; visual analog scale |
| spellingShingle | Manish Banjare Aditi Kaushal Deepali Valecha Nandini Bhatt K. K. Arora A randomized comparative study of patient-controlled epidural analgesia with manual standard intermittent bolus for labor analgesia Asian Journal of Medical Sciences labor analgesia; patient-controlled epidural analgesia; visual analog scale |
| title | A randomized comparative study of patient-controlled epidural analgesia with manual standard intermittent bolus for labor analgesia |
| title_full | A randomized comparative study of patient-controlled epidural analgesia with manual standard intermittent bolus for labor analgesia |
| title_fullStr | A randomized comparative study of patient-controlled epidural analgesia with manual standard intermittent bolus for labor analgesia |
| title_full_unstemmed | A randomized comparative study of patient-controlled epidural analgesia with manual standard intermittent bolus for labor analgesia |
| title_short | A randomized comparative study of patient-controlled epidural analgesia with manual standard intermittent bolus for labor analgesia |
| title_sort | randomized comparative study of patient controlled epidural analgesia with manual standard intermittent bolus for labor analgesia |
| topic | labor analgesia; patient-controlled epidural analgesia; visual analog scale |
| url | https://www.nepjol.info/index.php/AJMS/article/view/54656 |
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