Patient controlled epidural analgesia in labor

Specialties Ob/Gyn

Published

This was brought up to us by our anesthesiologist. Is anyone doing this with labor patients and how is it working compared to continuous epidural infusions?

We only do the controlled ones, it's absolutly great!!

And the mums are up pretty soon after they delivered.

BTW: about the showers: not alone, no way, I am always there in the BR with them, but they can take a shower after 2 hours.

Take care, Renee

We use patient controlled epidurals in our hospital. It runs via a pump and also delivers a continuous scheduled amount of epidural drug. The patient administers extra med. when they feel more is needed. It has a lockout and the patient cannot get "too much". This gives the patient more control on how much they want to feel as well as decrease the frequency of "top-off" or boluses administered by the anesthiologists.

Specializes in L&D, Ambulatory Care.

It is the same (as Ammer's post) at the hospital where I am doing my clinical, in most cases.

Some of the anesthesiologists don't give them a PCA pump.

I have only been there 2 days, but that is what I was told.

We use pt. controlled epidural pumps that can be programmed to provide a continuous infusion as well as providing the pt the availability to administer pre-set amounts of med with a lock-out of usually 10-20 minutes, depending on the anesthesiologist. What I have found with the pt being able to give additional amounts of meds, they tend to get a little too much of a good thing, and then have more difficulty in 2nd stage of labor.

Specializes in OB, Post Partum, Home Health.

We used PCEA for a very short time on a trial basis. I am not sure if we just didn't give it enough time and let our anesthesists get good at it or what, but it didn't seem to work very well. As I remember, there was a basal rate and pt could give bolus if she started to hurt, but the bolus never seemed to help, we almost always had to call anesth. to come and give her a bigger bolus. I have heard a lot of nurses that use it say that it works very well so I would love to give it another try.

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