Royal Alexandra Hospital Department of Anaesthetics
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PCEA (patient controlled epidural anaesthesia)
This is the default pump and protocol in the RAH.
The idea is that once
the effects of the loading dose begin to subside, the patient can self-administer a top-up via the pump.
Part of you r
consent process should include a bit of information about this:
She is advised to use the PCEA when she feels the return of contractions or when they become more intense.
The woman self-administers a bolus of local anaesthetic by pressing the button.
Theanalgesia will take around 15-20 minutes to be effective.
The pump will be available to administer another dose 10 minutes later, but each patient may only receive a maximum of three doses in an hour.

The anaesthetic nurses will usually set the pump up for you, but it is good practice to know how to do it. One of them will take you through it if you ask. The standard infusion bags are 100ml bags of 0.1% levo-bupivacaine with fentanyl 2μg.ml-1. Default pump settings are:
  • Infusion rate 5 ml/hr
  • 5 ml bolus.
  • 10 minute lockout.
  • Maximum of 20mls infused in one hour