The Clinical Study Of With Or Without Background Infusion In Patient-controlled Epidural Analgesia For Labor And Delivery

Objective Although PCEA during labor has been extensively studied in recent clinical trials,the role of a background infusion associated with self-administered boluses is still debated.The author designed a study to assess whether the use of PCEA with or without background infusion could improve the comfort of parturients and their satisfaction during labor and delivery without affecting the total consumption of local anesthetics.Methods Sixty laboring paturients requesting epidural analgesia administered via PCEA with a solution of 0.125%ropivacaine plus 2/ml fentanil were randomly assigned to two groups,according to the rate of background infusion used(0 and 5 ml/h)after 10ml 0.15%ropivacaine as the loading dose.Local anesthetic requirements,maternal satisfaction,verbal pain scores, incidence of side effects,and outcome of labor were compared among groups. Results Patient demographics,labor characteristics,side effects,and Apgar scores were similar in two groups.No significant differences were observed between groups in verbal pain scores during labor,number of supplemental boluses,or maternal satisfaction.A signifcantly greater overall total drug consumption with a 5ml/h background infusion(36.3±14.4ml)was observed in comparision with PCEA without a background infusion(22.7±6.9ml).Conclusion The results of this study suggest that the use of a background infusion with PCEA during labor leads to a greater consumption of anesthetics solution without improving comfort and satisfaction of parturients.Moreover,not using a background infusion does not provide an increased incidence of supplemental boluses and allows for a substantial reduction in the cost of analgesia.