Comparison of Patient Controlled Epidural Analgesia (PCEA) with basal infusion and Programmed Intermittent Epidural Bolus (PIEB) with PCEA in labour analgesia – A Year Retrospective Study / Zawiah Kassim ...[et al.]

Kassim, Zawiah and Mohd Nor, Norliza and Mokhtar, Ariffah and Mohamad, Suhaina and Osman, Sarina and Adnan, Isqandar (2021) Comparison of Patient Controlled Epidural Analgesia (PCEA) with basal infusion and Programmed Intermittent Epidural Bolus (PIEB) with PCEA in labour analgesia – A Year Retrospective Study / Zawiah Kassim ...[et al.]. Journal of Clinical and Health Sciences, 6 (1). pp. 23-31. ISSN 0127 – 984X

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Abstract

Introduction: Over three decades, patient-controlled epidural analgesia with a basal infusion regimen (PCEA+BI) has successfully improved labour analgesia quality due to its advantage in allowing self-titration by the parturients. Recently, a newer programmed intermittent epidural bolus with PCEA regimen (PIEB+PCEA) was suggested to improve the epidural spread of local anaesthetic hence resulted in better analgesia quality and higher maternal satisfaction. Methods: We conducted a one-year retrospective analysis of data from obstetric analgesia service record sheet and hospital information system comparing maternal satisfaction towards their labour analgesia quality, mode of delivery and neonatal Apgar scores between these two methods of epidural delivery techniques. A total of 343 parturients were recruited in this study (PCEA+BI n=171, PIEB+PCEA n=172). Results: There were no significant difference in maternal satisfaction between the two groups (P=0.398) with a higher percentage of excellent satisfaction were found in the PIEB+PCEA group (PIEB+PCEA 146/172 (84.9%) vs PCEA+BI 138/171 (80.7%)). No significant difference in the mode of delivery (P=0.296). However, the PIEB+PCEA group shown a higher spontaneous vaginal delivery rate (PIEB+PCEA 87/172 (50.6%) vs PCEA+BI 70/171 (40.9%) and lower Caesarean delivery rate (PIEB+PCEA 71/172 (41.3%) vs PCEA+BI 87/171 (50.9%)). Despite statistically significant differences found in Apgar scores at 1 minute (P=0.036), there was no significant difference in the scores at 5 minutes (P=0.107). Mean Apgar scores (SD) at 1 minute and 5 minutes for PIEB+ PCEA were 7.77(0.85) and 8.91(0.55) respectively and for PCEA + basal infusion, the scores for 1 minute and 5 minutes were 7.92(0.39) and 8.98(0.19) respectively. Conclusion: PIEB with PCEA is a newer epidural delivery technique for labour analgesia which produces a comparable outcome to PCEA with basal infusion.

Metadata

Item Type: Article
Creators:
Creators
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Kassim, Zawiah
UNSPECIFIED
Mohd Nor, Norliza
UNSPECIFIED
Mokhtar, Ariffah
UNSPECIFIED
Mohamad, Suhaina
UNSPECIFIED
Osman, Sarina
UNSPECIFIED
Adnan, Isqandar
UNSPECIFIED
Subjects: R Medicine > RG Gynecology and obstetrics
R Medicine > RG Gynecology and obstetrics > Obstetrics
Divisions: Universiti Teknologi MARA, Selangor > Puncak Alam Campus > Faculty of Medicine
Journal or Publication Title: Journal of Clinical and Health Sciences
UiTM Journal Collections: UiTM Journal > Journal of Clinical and Health Sciences (JCHS)
ISSN: 0127 – 984X
Volume: 6
Number: 1
Page Range: pp. 23-31
Official URL: https://jchs-medicine.uitm.edu.my/index.php
Item ID: 44353
Uncontrolled Keywords: Epidural analgesia, Programmed Intermittent Epidural Bolus (PIEB), Patient Controlled Epidural Analgesia (PCEA)
URI: https://ir.uitm.edu.my/id/eprint/44353

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44353

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