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ORIGINAL ARTICLE
Year : 2014  |  Volume : 30  |  Issue : 4  |  Page : 496-501

Comparison of computer-integrated patient-controlled epidural analgesia with no initial basal infusion versus moderate basal infusion for labor and delivery : A randomized controlled trial


1 Department of Women's Anaesthesia, KK Women's and Children's Hospital; Anesthesiology Program, Duke-NUS Graduate Medical School, Singapore Clinical Research Institute, Singapore
2 Department of Women's Anaesthesia, KK Women's and Children's Hospital, Singapore
3 Anesthesiology Program, Duke-NUS Graduate Medical School, Singapore Clinical Research Institute, Singapore
4 Centre for Quantitative Medicine, Duke-NUS Graduate Medical School; Singapore Clinical Research Institute, Singapore

Correspondence Address:
Ban Leong Sng
Department of Women's Anaesthesia, KK Women's and Children's Hospital, 100 Bukit Timah Road, Singapore - 229 899
Singapore
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0970-9185.142842

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Background and Aims: Computer-integrated patient-controlled epidural analgesia (CIPCEA) is a novel epidural drug delivery system. It automatically adjusts the basal infusion based on the individual's need for analgesia as labor progresses. Materials and Methods: This study compared the time-weighted local anesthetic (LA) consumption by comparing parturients using CIPCEA with no initial basal infusion (CIPCEA0) with CIPCEA with initial moderate basal infusion of 5 ml/H (CIPCEA5). We recruited 76 subjects after ethics approval. The computer integration of CIPCEA titrate the basal infusion to 5, 10, 15, or 20 ml/H if the parturient required respectively, one, two, three, or four patient demands in the previous hour. The basal infusion reduced by 5 ml/H if there was no demand in the previous hour. The sample size was calculated to show equivalence in LA consumption. Results: The time-weighted LA consumption between both groups were similar with CIPCEA0 group (mean [standard deviation (SD)] 8.9 [3.5] mg/H) compared to the CIPCEA5 group (mean [SD] 9.9 [3.5] mg/H), P = 0.080. Both groups had a similar incidence of breakthrough pain, duration of the second stage, mode of delivery, and patient satisfaction. However, more subjects in the CIPCEA0 group required patient self-bolus. There were no differences in fetal outcomes. Discussion: Both CIPCEA regimens had similar time-weighted LA consumption and initial moderate basal infusion with CIPCEA may not be required.


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