///2009 Abstract Details
2009 Abstract Details2019-08-03T15:55:31-06:00

PCEA versus Intermittent Dosing for Labor Analgesia: A Meta-analysis

Abstract Number: 185
Abstract Type: Meta Analysis/Review of the Literature

Kerry Blaha MD1 ; Jamie Murphy MD2; Gillian Newman MD, PhD3; Cristianna Vallera MD4; Marie Hanna MD5; Christopher Wu MD6

Objective: Patient-controlled epidural analgesia (PCEA) and intermittent epidural dosing are widely accepted methods for labor analgesia. The outcomes of duration of labor, Cesarean section, and instrumented deliveries of PCEA compared to intermittent epidural dosing are uncertain. We have performed a meta-analysis to further examine this issue.

Method: This project is exempt from the Johns Hopkins IRB. A systematic literature search of the National Library of Medicines PubMed database was conducted for terms related to PCEA for labor analgesia (epidural or extradural, patient-controlled or PCEA or patient controlled, labor or labour or pregnant or pregnancy or parturient). Only randomized controlled trials in the English language comparing PCEA to intermittent epidural dosing for labor analgesia were included for analysis. Data on pertinent study characteristics and relevant outcomes were extracted from accepted articles. Meta-analysis was performed using the Review Manager 4.2.10 (The Cochrane Collaboration, 2004). A random effects model was used.

Results: The literature search yielded 718 articles of which 8 met all inclusion criteria. There were a total of 169 subjects for the PCEA group and 161 for the intermittent epidural dosing group. Pooled estimates indicated that there were no difference in the duration of first stage (weighted mean difference [WMD] = -13.3 min, 95% confidence interval [CI]: -112.0, 85.4) or second stage (WMD = 4.9 min, 95% CI: -9.7, 19.5) of labor between the groups. There also was no difference in relative risk of Cesarean section (relative risk [RR] = 0.9, 95% CI: 0.5, 1.6) or instrumented deliveries (RR = 1.4, 95% CI: 0.9, 2.2) between the groups.

Conclusions: Our pooled analysis of PCEA versus intermittent epidural dosing for labor analgesia suggest that there are no significant differences in duration of labor, Cesarean section, and instrumented deliveries between the two methods for labor analgesia.

SOAP 2009