TY - JOUR
T1 - The effects of different epidural analgesia formulas on labor and mode of delivery in nulliparous women
AU - Chen, Shin Yan
AU - Lin, Pei Lin
AU - Yang, Yu Hsuan
AU - Yang, Ya Min
AU - Lee, Chien Nan
AU - Fan, Shou Zen
AU - Chen, Li Kuei
PY - 2014/1/1
Y1 - 2014/1/1
N2 - Objectives: Patient-controlled epidural analgesia (PCEA) and continuous epidural infusion (CEI) are popular and effective methods for pain relief during labor; however, there are concerns about increasing rates of cesarean section (C/S) and instrumental delivery. This prospective study investigated the effect of PCEA and CEI with different formulas on labor and the mode of delivery in nulliparous women. Materials and methods: A total of 480 nulliparous women were randomized into four groups, with 120 in each. Group A received a loading dose of 10mL of 1mg/mL ropivacaine with 2μg/mL fentanyl, then an intermittent bolus of 5mL with a background infusion of 5mL/hour by PCEA. Group B received the same PCEA formula as Group A with 0.8mg/mL bupivacaine. Group C received the same formula as Group A by CEI with 1mg/mL ropivacaine at a rate of 10mL/hour. Group D received the same formula as Group C with 0.8mg/mL bupivacaine. The rates of C/S and instrumental delivery and the incidence of side effects were recorded. Results: The rates of C/S were significantly different between Groups A and C, Groups A and D, and Groups B and D. The rates of instrumental delivery for normal spontaneous delivery were significantly different between Groups A and B, A and D, B and C, and C and D. Conclusion: The C/S rate was higher in Groups C and D; however, the instrumental delivery rate was lower in Groups A and C. We conclude that PCEA with 1mg/mL ropivacaine might provide the greatest benefit for labor analgesia.
AB - Objectives: Patient-controlled epidural analgesia (PCEA) and continuous epidural infusion (CEI) are popular and effective methods for pain relief during labor; however, there are concerns about increasing rates of cesarean section (C/S) and instrumental delivery. This prospective study investigated the effect of PCEA and CEI with different formulas on labor and the mode of delivery in nulliparous women. Materials and methods: A total of 480 nulliparous women were randomized into four groups, with 120 in each. Group A received a loading dose of 10mL of 1mg/mL ropivacaine with 2μg/mL fentanyl, then an intermittent bolus of 5mL with a background infusion of 5mL/hour by PCEA. Group B received the same PCEA formula as Group A with 0.8mg/mL bupivacaine. Group C received the same formula as Group A by CEI with 1mg/mL ropivacaine at a rate of 10mL/hour. Group D received the same formula as Group C with 0.8mg/mL bupivacaine. The rates of C/S and instrumental delivery and the incidence of side effects were recorded. Results: The rates of C/S were significantly different between Groups A and C, Groups A and D, and Groups B and D. The rates of instrumental delivery for normal spontaneous delivery were significantly different between Groups A and B, A and D, B and C, and C and D. Conclusion: The C/S rate was higher in Groups C and D; however, the instrumental delivery rate was lower in Groups A and C. We conclude that PCEA with 1mg/mL ropivacaine might provide the greatest benefit for labor analgesia.
KW - Analgesia
KW - Analgesic techniques (epidural)
KW - Anesthetics local (bupivacaine)
KW - Anesthetics local (ropivacaine)
KW - Patient-controlled analgesic techniques
UR - http://www.scopus.com/inward/record.url?scp=84899050457&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84899050457&partnerID=8YFLogxK
U2 - 10.1016/j.tjog.2012.01.039
DO - 10.1016/j.tjog.2012.01.039
M3 - Article
C2 - 24767638
AN - SCOPUS:84899050457
SN - 1028-4559
VL - 53
SP - 8
EP - 11
JO - Taiwanese Journal of Obstetrics and Gynecology
JF - Taiwanese Journal of Obstetrics and Gynecology
IS - 1
ER -