Combined spinal-epidural faster than continuous epidural in PCA.(Obstetrics)(patient-controlled analgesia )(Statistical data)

HOLLYWOOD, FLA. -- The addition of spinal analgesia to a routine walking epidural patient-controlled analgesia regimen shortened the time to pain relief in a randomized study.

In the study of 136 patients who were randomized to receive a combined spinal-epidural (CSE) regimen or a routine epidural regimen, the CSE group achieved full analgesia satisfaction in a mean of 8 minutes, compared with 16 minutes in the epidural group.

Moreover, the addition of spinal analgesia did not affect the quality of the block, side effects, or patient satisfaction with analgesia, Dr. Shaul Cohen reported in a poster at the annual meeting of the Society for Obstetric Anesthesia and Perinatology.

Patients in the CSE group received initiation by 2mg of intrathecal ropivacaine and 5 mcg sufentanil via a PENCAN 25G spinal needle followed by epidural patient-controlled analgesia (PCA). The epidural group received 20 mL of 0.04% ropivacaine plus 1 mcg/mL sufentanil plus 2 mcg/mL epinephrine epidural study solution followed by epidural PCA analgesia.

All patients received an infusion of the study solution at 4 mL/hr, and a PCA dose of 4 mL with a lockout time of 10 minutes, noted Dr. Cohen of the University of Medicine and Dentistry of New Jersey-Robert Wood Johnson Medical School, New Brunswick, N.J.

After the initial neuraxial dose ...