Why the study?
Does patient-controlled epidural analgesia improve pain relief or reduce dose requirements compared to continuous infusion or intermittent top-up in women during labour?
Does patient-controlled epidural analgesia improve pain relief or reduce dose requirements compared to continuous infusion or intermittent top-up in women during labour?
Patient-controlled epidural analgesia provides equivalent pain relief to continuous infusion during labour while significantly reducing hourly dose requirements and offering psychological benefits.
Supports PCEA to minimize dose in labor without efficacy loss; leaves open optimal regimens and need for RCTs.
Patient-controlled epidural analgesia, intermittent top-up and continuous infusion are equally effective in providing epidural pain relief during labour. Patient-controlled epidural analgesia is associated with a significant reduction in hourly dose requirements when compared with continuous infusion, and by transferring the responsibility for epidural top-up, it offers the parturient the psychological benefit of being in control. For these reasons, patient-controlled epidural analgesia may become the method of choice for epidural pain relief during labour. However, the safety of the method needs to be documented more extensively, and the advantage of a reduction in hourly dose requirements needs to be visualized in terms of an improvement in labour or neonatal outcome. Moreover, the optimal dose, drug combination and settings still remain to be determined.
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Rudolf Stienstra (2000) studied this question.
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