3 New epidural techniques for labour analgesia: patient-controlled epidural analgesia and combined spinal-epidural analgesia

Patient‐controlled epidural analgesia in labor does not always improve maternal satisfaction

“…A common belief is that patient‐controlled analgesia in labor is associated with increased maternal satisfaction, especially due to the enhanced feeling of control 3. In our study, however, the mothers in the IBEA group felt that they could influence their labor most.…”

“…It is an attractive option for labor analgesia, because it may offer advantages over intermittent bolus epidural analgesia or continuous infusion. Patient‐controlled epidural has been associated with reduced drug utilization and reduced rates of intervention or supplementation 2, 3. Greater maternal satisfaction is also a potential advantage of this method, although not confirmed in all studies 3, 4.…”

“…Patient‐controlled epidural has been associated with reduced drug utilization and reduced rates of intervention or supplementation 2, 3. Greater maternal satisfaction is also a potential advantage of this method, although not confirmed in all studies 3, 4. The increased satisfaction is often suggested to be associated with an enhanced feeling of control.…”

Ultraschall und Periduralanästhesie

“…Neben dem Literaturüberblick von Seebacher u. Malassine [13] gibt es in der wissenschaftlichen Literatur zahlreiche weitere Hinweise auf den besonderen Stellenwert von Regionalanästhesieverfahren bei Geburten [6,10], auch und gerade in risikoreichen Situationen [7]. Der relativ hohe technische Schwierigkeitsgrad der periduralen Punktion führt auch in jüngsten Veröffentlichungen noch zu der Forderung, sie einem erfahrenen Anästhesisten zu überlassen [3].…”

Patient‐controlled epidural technique improves analgesia for labor but increases cesarean delivery rate compared with the intermittent bolus technique

“…There are three principal techniques for providing epidural labor analgesia: intermittent bolus, continuous infusion, and patient-controlled infusion. Infusion techniques are increasingly used to provide analgesia, and the patient-controlled epidural infusion (PCEA) technique has been associated with high satisfaction among parturients (2)(3)(4)(5)(6)(7). The parturients' own ability to control the pain and the delivery may be even more important than the total pain relief in providing a satisfactory child birth experience (8).…”