Efficacy of patient controlled epidural analgesia during labor analgesia--a prospective randomized study using 0.1% bupivacaine with fentanyl 2 mg/ml

Epidural analgesia is the most effective for the control of pain during labor but irregularity of analgesia, toxicity of local anesthetics (LA) and driving block are the major limits of the modalities of maintenance. The purpose of this work was to assess the effectiveness and adverse effects of adaptations offered with Patient Controlled Epidural Analgesia (PCEA). 40 mono-foetal parturients were randomized in two groups: 0.1% bupivacaine continuous drip associated to fentanyl 2 lg/mL (CP-group) or same products administrated in PCEA. Evaluation of analgesia, driving and sensory block allows adapting the outputs of drip. Consumption schedule in LA was of 7.5+/-2 mL/h in the CP-group and 3.5+/-1.5 mL/h in PCEA-group (p < 0.05). Consumption accumulated by LA is reduced by 35 % from the very beginning and 43% a 4-th hour (p