(Anesth Analg. 2016;123(4):965–971)
Patients can still experience breakthrough pain under patient-controlled epidural analgesia (PCEA) with continuous epidural infusion (CEI). An alternative to PCEA with or without CEI is programmed intermittent epidural bolus (PIEB) of epidural analgesia. In the present study, the authors reviewed the potential for PIEB to improve maintenance of labor analgesia and discussed the current evidence for improving labor analgesia outcomes as well as considerations for the implementation of PIEB.