Comparison of Continuous Epidural Infusion of Bupivacaine and Fentanyl Versus Patient Controlled Analgesia Techniques for Labor Analgesia: A Randomized Controlled Trial (RCT)

Background: To diminish labor pain, several techniques have been used in developed countries. In the current randomized controlled trial, the use of epidural analgesia via PCEA pump with and without background infusion of analgesic was studied. Methods: In this double-blinded controlled trial, 60 women were enrolled and randomly assigned to study groups for receiving epidural analgesia during labor. All patients received initial bullous dose including 125 mg bupivacaine and 3 mg/ml fentanyl, and the first group patient (CI) received background infusion of 8 ml/hr and the second group (PCEA) received 10 ml bullous dose of 125 mg bupivacaine combined with 100 mcg fentanyl (2 ml) via epidural catheter. The Visual Analogue Scale (VAS) of 0-10 was measured 20 min after drug injection. The chi-square and student T-test were used for comparing variables between groups, and 0.05 was considered as the level of significance. Results: There was no significant difference in terms of demographic variables. Mean duration of the second stage of labor was significantly lower in patients received continuous infusion (CI) (p<0.0001). However, the total administered fentanyl dose was significantly higher in patients who underwent PCEA (p<0.0001). Besides, the CI group had a significantly lower rate of patient-controlled injection compared to PCEA patients (p<0.0001). However, there was no significant difference between patients’ satisfaction and VAS in study groups. Conclusion: Epidural analgesia using PCEA combined with continuous infusion did not provide higher analgesia or patients’ satisfaction compared to PCEA alone; however, it led to a decreased rate of drug injection and total administered dosage.