Leopoldo E Ferrer1, David J Romero2, Oscar I Vásquez2, Ednna C Matute2, Marc Van de Velde3. 1. Department of Anesthesiology, Hospital Fundación Santa Fe de Bogotá, Carrera 7 No. 117-15, Bogotá, Colombia. lfanesthesia@gmail.com. 2. Department of Anesthesiology, Hospital Fundación Santa Fe de Bogotá, Carrera 7 No. 117-15, Bogotá, Colombia. 3. Department of Anesthesiology, University Hospitals Gasthuisberg, Katholieke Universiteit Leuven, Oude Markt 13, 3000, Louvain, Belgium.
Abstract
PURPOSE:Continuous epidural infusion and programmed intermittent epidural boluses are analgesic techniques routinely used for pain relief in laboring women. We aimed to assess both techniques and compare them with respect to labor analgesia and obstetric outcomes. METHODS: After Institutional Review Board approval, 132 laboring women aged between 18 and 45 years were randomized to epidural analgesia of 10 mL of a mixture of 0.1% bupivacaine plus 2 µg/mL of fentanyl either by programmed intermittent boluses or continuous infusion (66 per group). Primary outcome was quality of analgesia. Secondary outcomes were duration of labor, total drug dose used, maternal satisfaction, sensory level, motor block level, presence of unilateral motor block, hemodynamics, side effects, mode of delivery, and newborn outcome. RESULTS: Patients in the programmed intermittent epidural boluses group received statistically less drug dose than those with continuous epidural infusion (24.9 vs 34.4 mL bupivacaine; P = 0.01). There was no difference between groups regarding pain control, characteristics of block, hemodynamics, side effects, and Apgar scores. CONCLUSIONS: Our study evidenced a lower anesthetic consumption in the programmed intermittent boluses group with similar labor analgesic control, and obstetric and newborn outcomes in both groups.
RCT Entities:
PURPOSE: Continuous epidural infusion and programmed intermittent epidural boluses are analgesic techniques routinely used for pain relief in laboring women. We aimed to assess both techniques and compare them with respect to labor analgesia and obstetric outcomes. METHODS: After Institutional Review Board approval, 132 laboring women aged between 18 and 45 years were randomized to epidural analgesia of 10 mL of a mixture of 0.1% bupivacaine plus 2 µg/mL of fentanyl either by programmed intermittent boluses or continuous infusion (66 per group). Primary outcome was quality of analgesia. Secondary outcomes were duration of labor, total drug dose used, maternal satisfaction, sensory level, motor block level, presence of unilateral motor block, hemodynamics, side effects, mode of delivery, and newborn outcome. RESULTS:Patients in the programmed intermittent epidural boluses group received statistically less drug dose than those with continuous epidural infusion (24.9 vs 34.4 mL bupivacaine; P = 0.01). There was no difference between groups regarding pain control, characteristics of block, hemodynamics, side effects, and Apgar scores. CONCLUSIONS: Our study evidenced a lower anesthetic consumption in the programmed intermittent boluses group with similar labor analgesic control, and obstetric and newborn outcomes in both groups.
Authors: Ban Leong Sng; Yanzhi Zeng; Nurun Nisa A de Souza; Wan Ling Leong; Ting Ting Oh; Fahad Javaid Siddiqui; Pryseley N Assam; Nian-Lin R Han; Edwin Sy Chan; Alex T Sia Journal: Cochrane Database Syst Rev Date: 2018-05-17