Comparison of PCIA with tramadol and combined spinal-epidural analgesia

Objective To evaluate the analgesic efficacy and safety of patient controlled intravenous analgesia (PCIA) with tramadol for labor analgesia as compared with combined spinal-epidural analgesia (CSEA) + patient controlled analgesia ( PCEA) with ropivacaine and fentanyl. Methods Eighty ASA Ⅰ - Ⅱ full term primigravidae in active labor (at 2 cm cervical dilation) who had a single fetus with vertex presentation and were expected to have a vaginal delivery were randomly divided into 3 groups: Ⅰ control group received no analgesia (n = 30), Ⅱ group A received CSEA + PCEA with ropivacaine and fentanyl (n = 30) and Ⅲ group B received PCIA with tramadol ( n = 20). In group A CSEA was performed at L2-3. Ropivacaine 2. 5 mg and fentanyl 5 mg were injected intrathecally. A catheter was then advanced 4 cm into epidural space cephalad for PCEA with a mixture of 0.1% ropivacaine with fentanyl 5 μg· μλ-1 (backgroud infusion 4 ml · h-1, demand bolus 4 ml with a 15 min lockout interval). In group B the loading