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

研究成果: ジャーナルへの寄稿学術誌査読

14 被引用数 (Scopus)

抄録

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.

本文言語英語
ページ(範囲)208-212
ページ数5
ジャーナルJournal of Anesthesia
19
3
DOI
出版ステータス出版済み - 8月 1 2005

!!!All Science Journal Classification (ASJC) codes

  • 麻酔学および疼痛医療

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