S. Tan et al., EXTRADURAL ANALGESIA IN LABOR - COMPLICATIONS OF 3 TECHNIQUES OF ADMINISTRATION, British Journal of Anaesthesia, 73(5), 1994, pp. 619-623
We have studied the complications associated with three techniques use
d to maintain extradural analgesia in labour: midwife top-up doses of
0.25% bupivacaine 10 ml, continuous infusion of 0.125% bupivacaine 10
ml h(-1) and patient-controlled extradural analgesia (PCEA) with self-
administered 3-ml bolus doses of 0.25% bupivacaine. A significantly hi
gher intervention rate by an anaesthetist was required in the continuo
us infusion group. There was no difference in the mode of delivery bet
ween the three groups, although some women in the continuous infusion
group had significantly denser motor block. There was a similar incide
nce of rectal pressure, unilateral block and missed segments in the-th
ree groups. Uneventful hypotension occurred in three women; two receiv
ing PCEA and one receiving continuous infusion. Ten women experienced
sensory blocks extending above T7 with no ill effects; seven receiving
PCEA and three continuous infusion.