Research Paper
Clinical investigation : Comparative study of Patient Controlled Epidural Analgesia ( PCEA) for labour pain using bupivacaine, bupivacaine with fentanyl or clonidine- prospective, double-blinded, randomized sequential-allocation study.
Author: Shaheen Bano1, Shashi Prakash2, Yashpal Singh3
1 Department of anaesthesiology, Institute of medical sciences, Varanasi, India 2 Dr. Shashi Prakash , Department of anaesthesiology, Institute of medical sciences, Varanasi, India
3 Department of Anaesthesiology, Institute of medical sciences, Varanasi, India.
Work conducted at:
Department of Anaesthesiology and Critical Care
Institute of Medical Sciences, BHU, Varanasi,
India
Name and Address of corresponding author and reprint request to:
Dr. Shashi Prakash
Assistant Professor,
Departmen
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Abstract :
Background
Patient-controlled epidural analgesia (PCEA) is new modality for labor analgesia that is useful, safe and effective technique. It does not only have the advantage of giving local anesthetic medication via continuous infusion but also covers differences in analgesic requirements.
In this study synthetic opioids fentanyl and α-2 agonist clonidine used with local anesthetic bupivacaine for comparison of pain relief using PCEA.
Methods
The participants were allocated randomly into one of the following groups according to the drugs used: Group B (n = 20): PCEA solution of 0.0625% bupivacaine alone. Group BF (n = 20): PCEA solution of 0.0625% bupivacaine with 2 mcg/ml fentanyl. Group BC (n = 20): PCEA solution of 0.0625% bupivacaine with 1.5 mcg/ml clonidine. Pain relief and hemodynamic parameter were observed.
Results
It was observed that pain relief was 100% (excellent analgesia) in 8, 14 and 12 patients in group
B, BF and BC respectively; 75% (good) in 8, 4 and 6 patients in group B, BF and BC respectively; 50% (satisfactory) in 4, 2 and 2 patients in group B, BF and BC respectively. None of the patients in any of the groups complained that there was no relief in pain after drug administration.
Conclusions
From this study, we conclude that the combination of fentanyl with bupivacaine definitely has an edge over bupivacaine-clonidine and bupivacaine alone in view of pain relief, satisfaction and adverse effects.
