A comparative study of patient controlled epidural analgesia (PCEA) and continuous infusion epidural analgesia (CIEA) during labour.

In a randomised, single-blinded, placebo-controlled study, 27 parturients in labour receiving epidural 0.125 per cent bupivacaine, were assessed to evaluate the efficacy of patientcontrolled epidural analgesia (PCEA) compared with continuous infusion epidural analgesia (CIEA). Group A (n = 14) received a background infusion of 4ml hr-1 0.125 per cent bupivacaine, with further 4 ml aliquots, self-administered, as required (up to 16 mi.hr-1). Group B (n = 11) received a continuous infusion of 12 ml.hr-1 through the same PCA apparatus, but with the demand-button deactivated. Both groups were similar in respect to age, height, weight, duration and outcome of labour, birthweight and neonatal Apgar scores. Patients in Group A (PCEA) received significantly less local anaesthetic than those in Group B (112 vs 15,2 mg.hr-1). Pain relief was similar in both groups. Patients expressed overall satisfaction with PCEA, appreciating control over their own pain relief and less reliance on medical staff. PCEA is a safe, effective means of providing optimal analgesia during labour, with minimal local anaesthetic requirement.