Join now to get access to this content and more.
Become a SOAP member and have access to our benefits.
- 2020 SOAP Virtual Meeting Series Videos
- For Review: SOAP Consensus Statement on Neuraxial Procedures in Thrombocytopenic Parturients
- Sample Centers of Excellence Applications
- ASA Corner
- SOAP Policy and Procedure Manual (P&P Manual)
- SOAP Expert Opinions
- SOAP's Learning Modules
- 2019 Annual Meeting Lecture Videos
- December 2018 - SOAP Unofficial Guide to ASA Committees Webinar
- Submit a Position
- View Job Postings
- Previous Meeting Archives
- Previous Meeting Abstract Search
- CMS Guidelines
- Member Benefits
- Newsletter Clinical Articles
- ACOG Documents
- Search our Patient Safety Archive
- Ask SOAP a Question
- Global Health Opportunities
- And more…
Improved Programmed Intermittent Epidural Bolus Volume Regimen in the Setting of Labor Analgesia
Abstract Number: O2-05
Abstract Type: Original Research
Background:Evidence suggests that programmed intermittent epidural bolus (PIEB) administration improves analgesia efficacy as compared continuous epidural infusion (CEI); however, the value of optimal PIEB volume remains unclear. We aimed to determine the optimal PIEB volume with the use of patient-controlled epidural analgesia (PCEA) to provide effective analgesia during labor.
Methods: In a prospective, randomized, double-blinded study, 428 laboring parturients requesting epidural analgesia were administered PCEA in 0.1% ropivacaine/0.33 ug/ml sufentanil and randomly assigned to four groups: CEI 8 (control group) received 8 ml/h continuous epidural infusion and PIEB groups received a 5-, 8-, and 10 ml/h programmed intermittent epidural bolus, respectively. The primary endpoint was the difference observed in VAS pain score seen among the four treated groups.
Results : Pain score was significantly lower in the PIEB 8 and PIEB 10 programmed intermittent epidural bolus groups versus the CEI 8 and PIEB 5 groups (P < 0.05). Hourly ropivacaine consumption was significantly lower in parturients receiving 5, and 8 ml/h PIEB than the other groups (P < 0.05). However, a higher PCEA rate were found in the CEI 8 and PIEB5 groups. Maternal satisfaction was significantly higher for PIEB 8 and 10 (P < 0.05). No differences in motor block, adverse events, instrumental delivery rate and neonatal outcomes were observed.
Conclusion: Observations suggest that PIEB 8 and 10 ml/h improves analgesia and patient satisfaction during labor with a reduced need for rescue by PCEA bolus without any adverse outcomes.