Epidural PCA with bupivacaine 0.125%, sufentanil 0.75 microgram and epinephrine 1/800.000 for labor analgesia: is a background infusion beneficial?

Eighty term parturients requesting epidural analgesia for labor pain treatment were randomly assigned to receive bupivacaine 0.125%, sufentanil 0.75 microgram/ml and epinephrine 1/800.000 by PCA modality with or without a basal rate of 3 ml/hr. A loading of 10 ml using the same mixture was administered while the PCA-demand dose consisted of 3 ml (lock out time 12 minutes). Total consumption, duration of labor, pain scores during the first and second stage of labor, maternal satisfaction and side-effects did not differ among both groups. Only when short labours were considered total consumption was lower in those treated with the demand modality only but they tended to experience more pain during the second stage. We conclude that for shortlasting labors, a low dose epidural PCA regimen results in a dose-sparing effect when compared to PCEA combined with a background infuson. For longer-lasting labors no differences between the two modalities could be observed.

RCT Entities:   Population Interventions Outcomes