Intermittent Epidural TOP-UPS vs Patient Control Epidural Analgesia During Labor

Vlatka Marijic, Damir Bukovic, Slobodan Mihaljevic, Slavko Oreskovic, Jasminka Persec, Tomislav Zupic, Josip Juras, Mirjana Radan


Pain during labor and delivery is often very unpleasant and stressful for the parturients. Patient controlled epidural analgesia (PCEA) has been found to be both safe and effective, providing optimal pain relief and allowing women to participate in their own analgesia). Compared to other epidural techniques, intermittent epidural top-ups and continuous epidural analgesia (CEA), PCEA uses diluted local anesthetic solutions with less motor block and less unscheduled clinician interventions. The purpose of our study was to compare intermittent bolus epidural top-ups and PCEA in labor. Sixty ASA I patients who requested epidural analgesia for labor and had written consent were included in the study. 30 patients in the first group received intermittent bolus epidural top-ups, while patients in the second group received PCEA. We evaluated duration of labor, maternal sense of pain using VAS scale and maternal satisfaction during fetal descent in both groups. We found that   the duration of labor was significantly shorter and maternal sense of pain was lower in the PCEA group than in the group receiving epidural bolus top-ups. There were no differences between groups in maternal satisfaction during fetal descent.


PCEA, intermittent bolus epidural analgesia, duration of labor, maternal sense of pain, diluted local anesthetic solutions

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