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

Epidural-PCA Analgesia for Labor Pain: Private versus Staff Patients

Abstract Number: 193
Abstract Type: Original Research

Shruti Shah M.D.1 ; Shaul Cohen M.D.2; Deeksha Chopra B.A.3; Renu Chhokra M.D.4; Chun Ho B.A.5; Christine W. Hunter M.D.6

INTRODUCTION: We compared our private parturients with our staff parturients with regards to epidural analgesia side effects, motor block, and labor outcome.

METHODS:Following IRB approval and informed consent, primiparae (P) and multiparae (M)) who requested epidural analgesia for labor pain during 1998 & 1999 were included. Group I (n=190): private primiparae, Group II (n=103): staff primiparae, Group III (n=192): private multiparae, and Group IV (n = 76): staff multiparae. After a test dose of 3ml 1.5% lidocaine + 5g/ml epinephrine, patients received ropivacaine (R) 0.1%, fentanyl 4g/ml and epinephrine 2g/ml as a 10ml loading dose followed by an infusion at 6ml/hr. Patients could administer a PCA dose of 2ml with lockout time of 10min (Abbott PCA pump). After administration of the loading dose (time = 0min), patients were queried with each contraction as to their satisfaction with analgesia. If at time = 20min, VAS>3, patients were given a 5ml bolus of the epidural solution every 10min for a maximum of 3 doses as needed until VAS<3. If analgesia was still inadequate (VAS>3), patients were rescued with 5ml of 0.25% R every 10min as needed to a maximum of 20ml. At each interval where intervention was required the infusion rate was increased by 2ml/hr to a maximum of 12ml/hr. Pain, nausea, pruritus, sedation, and motor block were evaluated hourly, or sooner if intervention was required. Patients were asked to rate their satisfaction for 1st stage, 2nd stage, and overall. Data were expressed as mean SD. Statistical analysis was performed with ANOVA or Fishers exact test as appropriate at p <0.05.

Table: 1

CONCLUSION: When compared with staff patients, our private patients were older, heavier, requested epidural analgesia earlier, complained more of itching, requested fewer rescue doses of R 0.25%, had heavier babies, and most strikingly, had higher C/S rate.

SOAP 2009