Article Text
Abstract
Background and Aims To analyze the efficacy, patient satisfaction, and clinical side effects of the epidural analgesia protocol in laboring patients at the Costa del Sol Hospital.
Methods Observational study in 31 patients.
The medication was accorded by the current protocol:
-Initial epidural bolus with bupivacaine0.125 - 0.25% 5 - 15 ml
-Continuous epidural infusion of bupivacaine0.0625% 8 - 12 ml/h
-Rescue medication boluses with bupivacaine0.125 - 0.25% 5 - 10 ml
Evaluated variables -Need for rescue boluses
-Pain before initial bolus
-Pain after initial bolus
-Time elapsed between initial bolus and analgesic rescues
-Side effects
-Patient satisfaction
Results -30 minutes after the first bolus, the EVA was 0–3 in 100% of the patients.
-54% of the patients analyzed required at least one rescue bolus due to pain during labor despite continuous epidural analgesic perfusion.
-70% of the patients requiring a rescue bolus reported obtaining good pain control until the end of labor.
-Low rate of adverse effects.
Conclusions The current epidural analgesia protocol at the Costa del Sol Hospital with continuous epidural perfusion of bupivacaine 0.0625% seems insufficient for pain control, especially in the first 4 hours needing rescue boluses.
Given the findings, it is possible to suggest changing the protocol to other methods with better pain control that do not depend on demand rescue boluses.