Programmed intermittent epidural bolus (PIEB) for labor pain relief

Abstract

Objective. To evaluate an effectiveness of the available modes of epidural analgesia (bolus, patient-controlled epidural analgesia, patient-controlled epidural analgesia combined with continuous epidural infusion, programmed intermittent epidural bolus combined with patient-controlled epidural analgesia) in parallel with a stepwise decrease in levobupivacaine concentration for analysis of optimal ratio «mode — concentration of anesthetic» in labor pain relief. Material and methods. We studied 145 women. The onset of pain relief was determined by regular labor. All women were divided into 5 groups depending on the mode of pain relief and local anesthetic concentration: on-demand manual boluses, patientcontrolled epidural analgesia (PCEA), patient-controlled epidural analgesia combined with continuous epidural infusion (PCEA + CEI), programmed intermittent epidural bolus combined with patient-controlled epidural analgesia (PIEB + PCEA); levobupivacaine 0.25 mg/ml; 1.25 mg/ml; 0.625 mg/ml. Labor pain relief efficacy was evaluated using a visual analogue scale. The time points for recording the values were as follows: before anesthesia, after 15 minutes from anesthesia onset, every 30 minutes until the uterine cervix is completely opened and during labor contractions at the delivery room. Анестезиология и реаниматология