The effects of different epidural analgesia formulas on labor and mode of delivery in nulliparous women

Shin Yan Chen, Pei Lin Lin, Yu Hsuan Yang, Ya Min Yang, Chien Nan Lee, Shou Zen Fan, Li Kuei Chen

Research output: Contribution to journalArticle

11 Citations (Scopus)


Objectives: Patient-controlled epidural analgesia (PCEA) and continuous epidural infusion (CEI) are popular and effective methods for pain relief during labor; however, there are concerns about increasing rates of cesarean section (C/S) and instrumental delivery. This prospective study investigated the effect of PCEA and CEI with different formulas on labor and the mode of delivery in nulliparous women. Materials and methods: A total of 480 nulliparous women were randomized into four groups, with 120 in each. Group A received a loading dose of 10mL of 1mg/mL ropivacaine with 2μg/mL fentanyl, then an intermittent bolus of 5mL with a background infusion of 5mL/hour by PCEA. Group B received the same PCEA formula as Group A with 0.8mg/mL bupivacaine. Group C received the same formula as Group A by CEI with 1mg/mL ropivacaine at a rate of 10mL/hour. Group D received the same formula as Group C with 0.8mg/mL bupivacaine. The rates of C/S and instrumental delivery and the incidence of side effects were recorded. Results: The rates of C/S were significantly different between Groups A and C, Groups A and D, and Groups B and D. The rates of instrumental delivery for normal spontaneous delivery were significantly different between Groups A and B, A and D, B and C, and C and D. Conclusion: The C/S rate was higher in Groups C and D; however, the instrumental delivery rate was lower in Groups A and C. We conclude that PCEA with 1mg/mL ropivacaine might provide the greatest benefit for labor analgesia.

Original languageEnglish
Pages (from-to)8-11
Number of pages4
JournalTaiwanese Journal of Obstetrics and Gynecology
Issue number1
Publication statusPublished - Jan 1 2014



  • Analgesia
  • Analgesic techniques (epidural)
  • Anesthetics local (bupivacaine)
  • Anesthetics local (ropivacaine)
  • Patient-controlled analgesic techniques

ASJC Scopus subject areas

  • Obstetrics and Gynaecology

Cite this