Low Dose Epidural Analgesia During Labor: Comparison Between Patient Controlled Epidural Analgesia with Basal Continuous Infusion and Intermittent Bolus Technique.

OBJECTIVES

To compare the efficacy and safety of patient controlled epidural analgesia with basal continuous infusion versus intermittent bolus for labor analgesia using fentanyl and bupivacaine.

METHODS

In this prospective study, 60 parturients having singleton term uncomplicated pregnancy in early active labor were included. 30 parturients were allocated to receive patient controlled epidural analgesia + basal continuous infusion (Group-A) and 30 received intermittent bolus on demand (Group-B). Efficacy of technique was assessed in terms of quality of analgesia on 0-10 cm verbal analogue scale. Effect on labor was assessed by duration of labor, mode of delivery, and parturient's satisfaction. Neonatal outcome was measured by Apgar score. Data were expressed as mean ± SD and analysed using Student 't' test and chi square test where appropriate. P < 0.05 was considered statistically significant.

RESULTS

Analgesic efficacy of both the groups was comparable. Maternal satisfaction was better in group A than in group B but the results did not achieve statistical significance. Effect on labor and neonatal outcome were comparable.

CONCLUSIONS

Both the techniques appear to be safe for the mother and neonate with excellent analgesic efficacy. In a busy obstetric unit with increased demand of epidural analgesia, patient controlled epidural analgesia with basal continuous infusion may be preferred.