International Journal of Obstetric Anesthesia
Volume 18, Issue 1 , Pages 28-32 , January 2009

A double-blind randomized controlled trial of patient-controlled epidural analgesia with or without a background infusion following initial spinal analgesia for labor pain

Presented in part at the annual meeting of ASA (American Society of Anesthesiologists), Chicago, IL, October 2006.

  • T. Okutomi

      Affiliations

    • Department of Anesthesiology and Kitasato University School of Medicine, Kanagawa, Japan
    • Corresponding Author InformationCorrespondence to: Toshiyuki Okutomi, M.D., Department of Anesthesiology, Kitasato University, 1-15-1 Kitasato, Sagamihara, Kanagawa 228-8555 Japan, Tel.: +81 42 778 8606; fax: +81 42 778 8441.
    • ,
  • M. Saito

      Affiliations

    • Department of Anesthesiology and Kitasato University School of Medicine, Kanagawa, Japan
    • ,
  • J. Mochizuki

      Affiliations

    • Department of Obstetrics and Gynecology, Kitasato University School of Medicine, Kanagawa, Japan
    • ,
  • K. Amano

      Affiliations

    • Department of Obstetrics and Gynecology, Kitasato University School of Medicine, Kanagawa, Japan
    • ,
  • S. Hoka

      Affiliations

    • Department of Anesthesiology and Kitasato University School of Medicine, Kanagawa, Japan

,Accepted 23 June 2008.

References 

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  2. Gambling DR, Huber CJ, Berkowitz J, et al. Patient-controlled epidural analgesia in labour: varying bolus dose and lockout interval. Can J Anaesth. 1993;40:211–217
  3. Ferrante FM, Rosinia FA, Gordon C, Datta S. The role of continuous background infusions in patient-controlled epidural analgesia for labor and delivery. Anesth Analg. 1994;79:80–84
  4. Curry PD, Pasco C, Heap DG. Patient-controlled epidural analgesia in obstetric anaesthetic practice. Pain. 1994;57:125–128
  5. van der Vyver M, Halpen S, Joseph G. Patient-controlled epidural analgesia versus continuous infusion for labour analgesia: a meta-analysis. Br J Anaesth. 2002;89:459–465
  6. Ledin Eriksson S, Gentele C, Olofsson CH. PCEA compared to continuous epidural infusion in an ultra-low-dose regimen for labor pain relief: a randomized study. Acta Anaesthesiol Scand. 2003;47:1085–1090
  7. Halpern S. Recent advances in patient-controlled epidural analgesia for labour. Curr Opin Anaesthesiol. 2005;18:247–251
  8. Stratmann G, Gambling DR, Moeller-Bertram T, Stackpole J, Pue AF, Berkowitz J. A randomized comparison of a five-minute versus fifteen-minute lockout interval for PCEA during labor. Int J Obstet Anesth. 2005;14:200–207
  9. Carvalho B, Cohen SE, Giarrusso K, Durbin M, Riley ET, Lipman S. “Ultra-light” patient-controlled epidural analgesia during labor: effects of varying regimens on analgesia and physician workload. Int J Obstet Anesth. 2005;14:223–229
  10. Paech MJ. Patient-controlled epidural analgesia in labour–is a continuous infusion of benefit?. Anaesth Intensive Care. 1992;20:15–20
  11. Petry J, Vercauteren M, Van Mol I, Van Houwe P, Adriaensen HA. Epidural PCA with bupivacaine 0.125%, sufentanil 0.75 microgram and epinephrine 1/800.000 for labor analgesia: is a background infusion beneficial?. Acta Anaesthesiol Belg. 2000;51:163–166
  12. Boselli E, Debon R, Cimino Y, Rimmele T, Allaouchiche B, Chassard D. Background infusion is not beneficial during labor patient-controlled analgesia with 0.1% ropivacaine plus 0.5 microg/ml sufentanil. Anesthesiology. 2004;100:968–972
  13. Missant C, Teunkenst A, Vandermeersch E, Van de Velde M. Patient-controlled epidural analgesia following combined spinal-epidural analgesia in labour: the effects of adding a continuous epidural infusion. Anaesth Intensive Care. 2005;33:452–456
  14. Bremerich DH, Waibel HJ, Mierdl S, et al. Comparison of continuous background infusion plus demand dose and demand-only parturient-controlled epidural analgesia (PCEA) using ropivacaine combined with sufentanil for labor and delivery. Int J Obstet Anesth. 2005;14:114–120
  15. Saito M, Okutomi T, Kanai Y, et al. Patient-controlled epidural analgesia during labor using ropivacaine and fentanyl provides better maternal satisfaction with less local anesthetic requirement. J Anesth. 2005;19:208–212
  16. Sia AT, Lim Y, Ocampo C. A comparison of a basal infusion with automated mandatory boluses in parturient-controlled epidural analgesia during labor. Anesth Analg. 2007;104:673–678
  17. Lyons GR, Kocarev MG, Wilson RC, Columb MO. A comparison of minimum local anesthetic volumes and doses of epidural bupivacaine (0.125% w/v and 0.25% w/v) for analgesia in labor. Anesth Analg. 2007;104:412–415
  18. Rawal N, Schollin J, Wesstrom G. Epidural versus combined spinal epidural block for cesarean section. Acta Anaesthesiol Scand. 1988;32:61–66
  19. Beaubien G, Drolet P, Girard M, Grenier Y. Patient-controlled epidural analgesia with fentanyl-bupivacaine: influence of prior dural puncture. Reg Anesth Pain Med. 2000;25:254–258
  20. Vartis A, Collier CB, Gatt SP. Potential intrathecal leakage of solutions injected into the epidural space following combined spinal epidural anaesthesia. Anaesth Intensive Care. 1998;26:256–261
  21. Thomas JA, Pan PH, Harris LC, Owen MD, D’Angelo R. Dural puncture with a 27-gauge Whitacre needle as part of a combined spinal-epidural technique does not improve labor epidural catheter function. Anesthesiology. 2005;103:1046–1051
  22. Sezer OA, Gunaydin B. Efficacy of patient-controlled epidural analgesia after initiation with epidural or combined spinal-epidural analgesia. Int J Obstet Anesth. 2007;16:226–230

PII: S0959-289X(08)00105-2

doi: 10.1016/j.ijoa.2008.06.006

International Journal of Obstetric Anesthesia
Volume 18, Issue 1 , Pages 28-32 , January 2009

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