Epidural 0.2% ropivacaine for labour analgesia: parturient-controlled or continuous infusion?

In this randomized, open study, we compared the incidence of lower limb motor block associated with epidural labour analgesia provided by parturient-controlled method (PCEA) with continuous infusion (CIEA) using 0.2% ropivacaine. The PCEA group (n = 20) received a demand-only regimen (bolus 5 ml, lockout 15 minutes). The rate of infusion of the CIEA group (n = 20) was 8 ml/h. We found that pain relief was not significantly different between the two groups, although the PCEA group had a higher satisfaction score (P < 0.05). Fewer parturients in the PCEA group had lower limb motor block (6 vs 14, P < 0.05). The total volume of ropivacaine used per hour was also lower in the PCEA group (median 8.75 vs 10.5 ml, P < 0.05). No difference in the maternal or fetal outcome was detected. We conclude that PCEA with ropivacaine is an effective mode of analgesia which is dose-sparing and produces less motor block in comparison with CIEA.