Paper
Saturday, 22 July 2006
The Use of Patient Controlled Epidural Compared to Continuous Infusion Epidural Analgesia and the Effect in Childbirth Satisfaction
Ana-Maria Gallo, PhD, CNS, RNC, Perinatal, Sharp Mary Birch Hospital for Women, San Diego, CA, USA and Susan Faron, RNC, MN, CNS, Labor and Delivery, PACU, and Women's Acute Care, Sharp Mary Birch Hospital for Women, San Diego, CA, USA.
| Learning Objective #1: Describe the use of Patient Controlled Epidural Analgesia. |
| Learning Objective #2: Describe the use of PCEA and its effect to personal control and childbirth satisfaction. |
Epidural regional anesthesia is effective and the most commonly used analgesia in laboring patients. This type of anesthesia relieves the discomfort of contractions and the pain associated with childbirth. The major disadvantage of this type of anesthesia is that it is a continuous infusion of medication resulting in a temporary (partial to complete) motor paralysis. A recent alternative is the Patient Controlled Epidural Analgesia (PCEA), which allows the patient to relieve her pain by giving herself the desired amount of medication. Obstetrical patients, who are in control of their pain medication, are able to regain partial motor function due to the use of less medication, regain partial motor function and push move effectively. The purpose of this study is to examine the influence of personal control on pain relief and childbirth satisfaction.
This prospective cohort observational study was conducted in two in Southern, California system hospitals. A sample of 118 women who delivered vaginally at term and received epidural analgesia either by a patient controlled analgesia device and continuous infusion were included in the study.
Items on the questionnaires were design to explore three variables; personal control, satisfaction with pain relief and satisfaction with the childbirth experience. The instruments utilized in this study were the Personal Control Scale and the Labor Agentry Scale. Descriptive analysis was performed on the demographic information. Analysis of Variance, Nonparametric Statistic Correlation and Hierarchical Regression Analysis were performed. The level of significance was set at 0.05. Cronbach’s alpha coefficient were calculated to examine internal consistency.
The results in this study suggest that the patient control epidural anesthesia does influence personal control during childbirth. Women who receive the patient control epidural anesthesia experiences more personal control during childbirth, as measured by the Labor Agentry Scale, then women who received continues infusion epidural anesthesia.
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