Abstract:
BACKGROUND:Patient-controlled epidural analgesia, PCEA, has been introduced in obstetric analgesia during the past decade. Many studies have shown that the consumption of analgesic is reduced when the parturient requests her own doses. This study investigates whether this is also true when using an ultra-low-dose regimen. METHODS:Eighty parturients were prospectively randomized to have either continuous epidural infusion (CEI) with ropivacaine 1 mg ml-1 and sufentanil 0.5 micro g ml-1, 6 ml h-1, or patient-controlled epidural analgesia (PCEA) with 4 ml demand doses with 20 min' lockout. The epidural start dose was the same for the two groups, 8 ml of the study solution. Rescue bolus doses were given when needed and the continuous infusion could be increased, which gave the two groups the same maximum possible dose. The consumption of local ropivacaine in combination with sufentanil during labor was registered. Hourly assessments made throughout labor included pain intensity documented with visual analog score, VAS, the patient's opinion on epidural efficacy, motor block, pruritus and need for nitrous oxide. RESULTS:The PCEA group consumed 33% less of the study solution than the CEI group. Mean total consumption was 35 ml (SD 18.0) and 52 ml (SD 19.6), respectively. Mean hourly consumption was 5.2 ml h-1 (SD 2.54) in the PCEA group and 6.9 ml h-1 (SD 1.31) in the CEI group. There were no significant differences between the two groups in pain relief, epidural efficacy, side-effects or obstetric outcome. CONCLUSION:PCEA reduces doses compared to continuous infusion even when ultra-low-dose local anesthetic with opioid is used. The PCEA technique provides individual titration of doses to an acceptable degree of pain relief.
journal_name
Acta Anaesthesiol Scandjournal_title
Acta anaesthesiologica Scandinavicaauthors
Ledin Eriksson S,Gentele C,Olofsson CHdoi
10.1034/j.1399-6576.2003.00207.xsubject
Has Abstractpub_date
2003-10-01 00:00:00pages
1085-90issue
9eissn
0001-5172issn
1399-6576pii
207journal_volume
47pub_type
临床试验,杂志文章,随机对照试验abstract::N-methyl-D-aspartate (NMDA) receptors are involved in the development of neuropathic pain. Ketamine, a non-competitive NMDA receptor antagonist, has in several case reports given pain relief but efficacy in dosages tolerated in long-term ketamine treatment is unknown. Another substance with an antagonist action at NMD...
journal_title:Acta anaesthesiologica Scandinavica
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pub_type: 杂志文章,多中心研究
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journal_title:Acta anaesthesiologica Scandinavica
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journal_title:Acta anaesthesiologica Scandinavica
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journal_title:Acta anaesthesiologica Scandinavica
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pub_type: 杂志文章
doi:10.1111/j.1399-6576.1997.tb04608.x
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journal_title:Acta anaesthesiologica Scandinavica
pub_type: 杂志文章
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journal_title:Acta anaesthesiologica Scandinavica
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pub_type: 杂志文章,随机对照试验
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更新日期:2011-03-01 00:00:00
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journal_title:Acta anaesthesiologica Scandinavica
pub_type: 临床试验,杂志文章,随机对照试验
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pub_type: 杂志文章
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更新日期:1984-08-01 00:00:00
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pub_type: 杂志文章
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更新日期:2007-05-01 00:00:00