U Leone Roberti Maggiore1, R Silanos2, S Carlevaro3, A Gratarola2, P L Venturini4, S Ferrero4, P Pelosi3. 1. Unit of Obstetrics and Gynecology, IRCCS AOU San Martino - IST, Genova, Italy. Electronic address: ulrm@me.com. 2. Anesthesiology Unit, IRCCS San Martino Hospital and National Institute for Cancer Research, University of Genoa, Genoa, Italy. 3. Department of Surgical Sciences and Integrated Diagnostics, IRCCS AOU San Martino Hospital and National Institute for Cancer Research, University of Genoa, Genoa, Italy. 4. Unit of Obstetrics and Gynecology, IRCCS AOU San Martino - IST, Genova, Italy; Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DiNOGMI), University of Genova, Italy.
Abstract
BACKGROUND: Pain is a major concern during medical abortion but no evidence-based recommendations for optimal analgesia during medical termination of pregnancy are available. We compared two methods of epidural analgesia during second trimester termination of pregnancy, with the primary aim of assessing the incidence of motor block. METHODS: Women were randomly assigned to receive continuous epidural infusion (CEI Group; n=52) or programmed intermittent epidural bolus (PIEB Group; n=52). Assessment of motor block was performed every hour. Patients with a modified Bromage score <6 were considered to have motor block. RESULTS:Motor block occurred more frequently in the CEI Group compared with the PIEB Group (46.2% vs. 5.8%, P<0.001). Pain scores were low and comparable between groups. Patients in the CEI Group experienced nausea more frequently than those in the PIEB Group (34.6% vs. 13.5%, P=0.022). The degree of satisfaction was higher in the PIEB Group compared with the CEI Group. CONCLUSIONS: During second trimester termination of pregnancy in our patient groups, a programmed intermittent epidural bolus technique was associated with less motor block and greater patient satisfaction than continuous epidural infusion. Both techniques had similar analgesic efficacy.
RCT Entities:
BACKGROUND:Pain is a major concern during medical abortion but no evidence-based recommendations for optimal analgesia during medical termination of pregnancy are available. We compared two methods of epidural analgesia during second trimester termination of pregnancy, with the primary aim of assessing the incidence of motor block. METHODS:Women were randomly assigned to receive continuous epidural infusion (CEI Group; n=52) or programmed intermittent epidural bolus (PIEB Group; n=52). Assessment of motor block was performed every hour. Patients with a modified Bromage score <6 were considered to have motor block. RESULTS: Motor block occurred more frequently in the CEI Group compared with the PIEB Group (46.2% vs. 5.8%, P<0.001). Pain scores were low and comparable between groups. Patients in the CEI Group experienced nausea more frequently than those in the PIEB Group (34.6% vs. 13.5%, P=0.022). The degree of satisfaction was higher in the PIEB Group compared with the CEI Group. CONCLUSIONS: During second trimester termination of pregnancy in our patient groups, a programmed intermittent epidural bolus technique was associated with less motor block and greater patient satisfaction than continuous epidural infusion. Both techniques had similar analgesic efficacy.
Authors: Maria Belen Rodríguez-Campoó; Antonio Curto; Manuel González; Cesar Aldecoa Journal: J Clin Monit Comput Date: 2018-11-30 Impact factor: 2.502