387
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Comparison of patient-controlled and nurse-administered analgesia using intravenous fentanyl during labor . Preliminary observations have shown that fentanyl citrate , a potent narcotic , is helpful during labor without undue side effects . This randomized prospective investigation compared the patient-controlled administration of fentanyl with that of administration by nurses on request . Eighty healthy women beginning active labor ( cervical dilation 4 cm ) at term were assigned to receive fentanyl intravenously by either patient-controlled administration ( n=37 ) or nurse administration on demand ( n=43 ) . Pain intensity measurements during early and late labor revealed the degree of analgesia to be the same in both groups . The delay in setting up the infusion system and the short time between requesting analgesia and vaginal delivery were limitations with self-administration . Maternal oversedation and vomiting did not occur . Neonatal naloxone therapy was used infrequently , umbilical serum levels of fentanyl were the same in both groups , and postnatal neuroadaptive testing revealed comparable results in both groups . Despite the usefulness of fentanyl during labor , administration by the patient had no advantages over administration by the nurses in significantly reducing drug use , improving pain relief , or avoiding drowsiness .
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Intervention_Pharmacological
patient-controlled and nurse-administered analgesia
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Intervention_Pharmacological
fentanyl citrate
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Intervention_Other
patient-controlled administration of fentanyl
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Intervention_Other
administration by nurses on request
392
Intervention_Physical
fentanyl
393
Intervention_Other
patient-controlled administration
394
Intervention_Other
nurse administration on demand
395
Intervention_Other
administration by the patient
396
Intervention_Other
administration by the nurses
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Outcome_Pain
Pain intensity measurements
398
Outcome_Pain
degree of analgesia
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Outcome_Other
time between requesting analgesia and vaginal delivery
400
Outcome_Adverse-effects
Maternal oversedation and vomiting
401
Outcome_Other
Neonatal naloxone therapy
402
Outcome_Adverse-effects
umbilical serum levels of fentanyl
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Outcome_Physical
postnatal neuroadaptive testing
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Outcome_Other
drug use
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Outcome_Pain
improving pain relief
406
Outcome_Physical
avoiding drowsiness
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Participant_Condition
during labor .
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Participant_Condition
Eighty healthy women beginning active labor ( cervical dilation 4 cm ) at term were assigned to receive fentanyl intravenously by either patient-controlled administration ( n=37 ) or nurse administration on demand ( n=43 )