Patient-controlled epidural analgesia during labor using ropivacaine and fentanyl provides better maternal satisfaction with less local anesthetic requirement

Miwako Saito, Toshiyuki Okutomi, Yuji Kanai, Junko Mochizuki, Akihiro Tani, Kan Amano, Sumio Hoka

Research output: Contribution to journalArticle

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Abstract

Purpose. To test the hypothesis that patient-controlled epidural analgesia (PCEA) using ropivacaine and fentanyl provides better maternal satisfaction and less anesthetic requirement than conventional continuous epidural infusion (CEI) during labor, we studied 58 uncomplicated parturients (singleton, vertex presentation). Methods. After establishing effective epidural analgesia with 11 ml of 0.2% ropivacaine, all parturients were randomly divided into one of two groups: the PCEA group (n = 29) or the CEI group (n = 29). In the PCEA group, the pump was initiated to deliver a basal infusion at 6 ml·h-1 and a demand dose of 5 ml; the lockout interval was 10 min, and there was a 31 ml·h-1 limit. The drugs used were 0.1% ropivacaine + fentanyl 2 μg·ml-1. In the CEI group, epidural analgesia was maintained with the same solution as the PCEA group at a constant rate of 10 ml·h-1. If parturients requested additional analgesia in the CEI group, we added 8 ml of epidural 0.2% ropivacaine without fentanyl. Results. Parturients' demographic data, such as duration of labor, mode of delivery, Apgar score, and umbilical arterial pH did not differ between the two groups. However, the hourly requirement of ropivacaine was significantly less in the PCEA group than in the CEI group (9.3 ± 2.5 vs. 17.6 ± 7.6 mg·h-1; P < 0.05). Parturients' satisfaction assessed by the Visual Analogue Scale tended to be higher in the PCEA group than in the CEI group. Side effects such as nausea, hypotension, and itching were similar for the two groups. Conclusion. We found that PCEA was an effective means of providing optimal analgesia, with better satisfaction during labor and less local anesthetic requirement.

Original languageEnglish
Pages (from-to)208-212
Number of pages5
JournalJournal of Anesthesia
Volume19
Issue number3
DOIs
Publication statusPublished - Aug 1 2005

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Patient-Controlled Analgesia
Epidural Analgesia
Fentanyl
Local Anesthetics
Mothers
Parturition
Analgesia
Umbilicus
ropivacaine
Apgar Score
Pruritus
Visual Analog Scale
Hypotension
Nausea
Anesthetics
Demography

All Science Journal Classification (ASJC) codes

  • Anesthesiology and Pain Medicine

Cite this

Patient-controlled epidural analgesia during labor using ropivacaine and fentanyl provides better maternal satisfaction with less local anesthetic requirement. / Saito, Miwako; Okutomi, Toshiyuki; Kanai, Yuji; Mochizuki, Junko; Tani, Akihiro; Amano, Kan; Hoka, Sumio.

In: Journal of Anesthesia, Vol. 19, No. 3, 01.08.2005, p. 208-212.

Research output: Contribution to journalArticle

Saito, Miwako ; Okutomi, Toshiyuki ; Kanai, Yuji ; Mochizuki, Junko ; Tani, Akihiro ; Amano, Kan ; Hoka, Sumio. / Patient-controlled epidural analgesia during labor using ropivacaine and fentanyl provides better maternal satisfaction with less local anesthetic requirement. In: Journal of Anesthesia. 2005 ; Vol. 19, No. 3. pp. 208-212.
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abstract = "Purpose. To test the hypothesis that patient-controlled epidural analgesia (PCEA) using ropivacaine and fentanyl provides better maternal satisfaction and less anesthetic requirement than conventional continuous epidural infusion (CEI) during labor, we studied 58 uncomplicated parturients (singleton, vertex presentation). Methods. After establishing effective epidural analgesia with 11 ml of 0.2{\%} ropivacaine, all parturients were randomly divided into one of two groups: the PCEA group (n = 29) or the CEI group (n = 29). In the PCEA group, the pump was initiated to deliver a basal infusion at 6 ml·h-1 and a demand dose of 5 ml; the lockout interval was 10 min, and there was a 31 ml·h-1 limit. The drugs used were 0.1{\%} ropivacaine + fentanyl 2 μg·ml-1. In the CEI group, epidural analgesia was maintained with the same solution as the PCEA group at a constant rate of 10 ml·h-1. If parturients requested additional analgesia in the CEI group, we added 8 ml of epidural 0.2{\%} ropivacaine without fentanyl. Results. Parturients' demographic data, such as duration of labor, mode of delivery, Apgar score, and umbilical arterial pH did not differ between the two groups. However, the hourly requirement of ropivacaine was significantly less in the PCEA group than in the CEI group (9.3 ± 2.5 vs. 17.6 ± 7.6 mg·h-1; P < 0.05). Parturients' satisfaction assessed by the Visual Analogue Scale tended to be higher in the PCEA group than in the CEI group. Side effects such as nausea, hypotension, and itching were similar for the two groups. Conclusion. We found that PCEA was an effective means of providing optimal analgesia, with better satisfaction during labor and less local anesthetic requirement.",
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AU - Saito, Miwako

AU - Okutomi, Toshiyuki

AU - Kanai, Yuji

AU - Mochizuki, Junko

AU - Tani, Akihiro

AU - Amano, Kan

AU - Hoka, Sumio

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