As compared to remifentanil patient-controlled analgesia (RPCA), the use of CSEA proved effective in terms of analgesia and patient satisfaction, a study issued in Ginekologica polska journal illustrated. Also, when neuraxial analgesia is not available or contraindicated, RPCA can offer a satisfactory experience with the compulsory presence of a midwife for the management of hypoventilation.

This prospective observational study by Iva Blajic et al. is based on the hypothesis that CSEA would provide improved and more sustained pain alleviation compared to RPCA. Overall, 161 multiparous women were divided into RPCA group (80 women) and CSEA (81 women) to compare their analgesic efficacy using the numeric rating scale (NRS), satisfaction with pain relief, adverse events reported, and labour progress.

Considerable pain reduction was witnessed in both the groups after 15 minutes as compared to the baseline. During the entire labour, CSEA was successful in considerably lowering pain:

CSEA provided higher satisfaction and more patients with CSEA chose the same procedure for the next labour. The use of RPCA was linked with apnoea (25%), desaturation (34%), and bradypnea (21%), that were temporary and managed without difficulty. Severe sedation was not reported. All neonates had encouraging Apgar scores (> 8). Thus, in multiparous females, CSEA offers superior analgesia and satisfaction when compared with RPCA.