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Abstract:
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  1. Zawiah Kassim, Norliza Mohd Nor, Ariffah Mokhtar, Suhaina Mohamad, Sarina Osman, Isqandar Adnan
    MyJurnal
    Introduction: Over three decades, patient-controlled epidural analgesia with a basal infusion
    regimen (PCEA+BI) has successfully improved labour analgesia quality due to its advantage
    in allowing self-titration by the parturients. Recently, a newer programmed intermittent epidural
    bolus with PCEA regimen (PIEB+PCEA) was suggested to improve the epidural spread of
    local anaesthetic hence resulted in better analgesia quality and higher maternal satisfaction.
    Methods: We conducted a one-year retrospective analysis of data from obstetric analgesia
    service record sheet and hospital information system comparing maternal satisfaction towards
    their labour analgesia quality, mode of delivery and neonatal Apgar scores between these two
    methods of epidural delivery techniques. A total of 343 parturients were recruited in this study
    (PCEA+BI n=171, PIEB+PCEA n=172). Results: There were no significant difference in
    maternal satisfaction between the two groups (P=0.398) with a higher percentage of excellent
    satisfaction were found in the PIEB+PCEA group (PIEB+PCEA 146/172 (84.9%) vs PCEA+BI
    138/171 (80.7%)). No significant difference in the mode of delivery (P=0.296). However, the
    PIEB+PCEA group shown a higher spontaneous vaginal delivery rate (PIEB+PCEA 87/172
    (50.6%) vs PCEA+BI 70/171 (40.9%) and lower Caesarean delivery rate (PIEB+PCEA 71/172
    (41.3%) vs PCEA+BI 87/171 (50.9%)). Despite statistically significant differences found in
    Apgar scores at 1 minute (P=0.036), there was no significant difference in the scores at 5
    minutes (P=0.107). Mean Apgar scores (SD) at 1 minute and 5 minutes for PIEB+ PCEA were
    7.77(0.85) and 8.91(0.55) respectively and for PCEA + basal infusion, the scores for 1 minute
    and 5 minutes were 7.92(0.39) and 8.98(0.19) respectively. Conclusion: PIEB with PCEA is
    a newer epidural delivery technique for labour analgesia which produces a comparable
    outcome to PCEA with basal infusion.
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