Patient satisfaction between remifentanil patient-controlled analgesia and epidural analgesia for labor pain

Abstract

Introduction: The aim of this study was to compare patient satisfaction between remifentanil patient-controlled analgesia (RPCA) and epidural analgesia (EA) for labor pain.

Material and methods: This prospective cohort study was carried out on primiparous women requesting analgesia for labor at a Teaching Hospital, Amsterdam, the Netherlands. Women self-selected the analgesia of choice (RPCA n = 166 and EA n = 124) and were asked to complete the Woman's Views of Birth Labour Satisfaction Questionnaire (WOMBSLQ), within 24 h (T0), 3 months (T3) and 6 months (T6) after birth. The WOMBSLQ comprises 11 subscales, including pain during labor and general satisfaction. The main outcome measure was general satisfaction.

Results: There was no significant difference in the subscale of general satisfaction with labor and delivery (maximum of 14 points) between both groups at all three time points [median score at T0 for RPCA was 12 vs. 13 for the EA group (p = 0.95); at T3: 12 vs. 12, respectively (p = 0.41); and at T6: 12 vs. 12, respectively (p = 0.69)]. Women in the EA group had significantly better pain relief (maximum of 21 points) at all three time points [median score at T0 for RPCA was 14 vs. 18 for the EA group (p < 0.001); at T3: 13 vs. 17, respectively (p = 0.002); and at T6: 13 vs. 17, respectively (p = 0.003)].

Conclusion: Both self-selected groups did not differ in general satisfaction with labor and delivery at all three time points after birth despite a significantly higher experienced pain in the RPCA group.

Keywords: Analgesia; epidural analgesia; labor pain; obstetrics; patient-controlled analgesia; remifentanil.