Programmed Intermittent Epidural Boluses for Maintenance of Labor Analgesia: An Impact Study

Abstract

(IJOA. 2016;26:32–38)

Maintenance of epidural labor analgesia has evolved from manual boluses to continuous infusions to patient-controlled boluses. Patient-controlled epidural analgesia (PCEA) in the presence or absence of a background continuous epidural infusion (CEI) is a common technique for providing labor analgesia. Programmed intermittent epidural bolus (PIEB) is an automated technique that provides fixed boluses of local anesthetic with or without opioid at scheduled intervals. It can be used as an alternative to CEI alone or CEI with PCEA. This current study aimed to compare PIEB+PCEA administration to CEI+PCEA administration for labor analgesia. The hypothesis was that PIEB would reduce the number of patients requiring clinician boluses compared to CEI.