Background: Continuous epidural infusion (CEI) has been an optimal and acceptable technique for inducing epidural anesthesia. This study compared two methods of programmed intermittent epidural bolus (PIEB) with CEI in labor analgesia among patients receiving epidural dexmedetomidine.

Methods: This study was a randomized clinical trial. The target population was term women candidates for epidural anesthesia. After selection of sample size based on inclusion criteria, a total of 3 cc of dexmedetomidine (0.5 µg/ml) and Ropivacaine 0.1% was injected. Furthermore, 5 ml was injected as a loading dose of dexmedetomidine 0.5 µg /ml and Ropivacaine 0.1%. Then the pain score was recorded. SPSS software Version 23 was used for statistical analysis of data.

Results: The neonatal Apgar score in PIEB method was more improved (P = 0.003) and the use of assisted delivery tools such as vacuum, in PIEB method was reduced. (p=0.038) Duration of the first phase of the labor in this method was more reduced than CEI.(p=0.015) Patients in the group undergoing epidural anesthesia by PIEB method were associated with a higher level of satisfaction with the delivery process (p < 0.05) than patients undergoing CEI protocol.

Conclusion: PIEB method is associated with further improvement in neonatal Apgar score and maternal outcomes (reduction in the duration of the first phase of labor and no need to use assisted delivery methods) compared to the CEI protocol, but has little effect on hemodynamic conditions or drug dosage.

Download full-text PDF

Source
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC10646366PMC
http://dx.doi.org/10.22088/cjim.14.4.648DOI Listing

Publication Analysis

Top Keywords

pieb method
16
epidural anesthesia
12
labor analgesia
8
ropivacaine 01%
8
neonatal apgar
8
apgar score
8
assisted delivery
8
method reduced
8
duration phase
8
phase labor
8

Similar Publications

Initiation and maintenance of neuraxial labour analgesia: A narrative review.

Best Pract Res Clin Anaesthesiol

September 2024

Department of Anaesthesiology, GZA Hospitals, Antwerp, Belgium.

Labour analgesia is a crucial aspect of obstetric anaesthesia, aiming to alleviate pain during childbirth while ensuring maternal and foetal safety. Over the past decade, advancements in labour analgesia techniques have evolved, impacting initiation, maintenance, and outcomes. We emphasize the longstanding importance of epidural analgesia while recognizing the growing significance of combined spinal-epidural and dural puncture epidural techniques for labour initiation.

View Article and Find Full Text PDF

Background: Interval time, defined as the period of time that effective analgesia can be achieved without the need for patient-controlled epidural analgesia (PCEA), has been investigated as an important parameter for the design of programmed intermittent epidural bolus (PIEB) approaches to labor analgesia. PCEA approaches offer flexibility in the management of labor-related pain while minimizing the risk of patient overdose. Here, the optimal interval between PIEB boluses of 0.

View Article and Find Full Text PDF

Background: Labor analgesia can be achieved by different approaches. The efficacy and safety of combined dural puncture epidural (DPE) with program intermittent epidural bolus (PIEB) are not well characterized. This study aimed to compare the efficacy and safety of DPE combined with PIEB vs epidural (EP) combined with PIEB for labor analgesia.

View Article and Find Full Text PDF

Programmed Intermittent Epidural Bolus vs Manual Epidural Bolus for Labor Analgesia Initiation: A Randomized Non-Inferiority Trial.

Drug Des Devel Ther

November 2024

Department of Anesthesiology, Shanghai Key Laboratory of Maternal Fetal Medicine, Shanghai Institute of Maternal-Fetal Medicine and Gynecologic Oncology, Shanghai First Maternity and Infant Hospital, School of Medicine, Tongji University, Shanghai, 200092, People's Republic of China.

Article Synopsis
  • This study compares the effectiveness of a programmed intermittent epidural bolus (PIEB) versus a manual bolus for the initial loading dose of labor analgesia in 164 parturients.
  • The main finding is that shortly after administration, both methods provided similar levels of adequate pain relief, with 75.61% for manual and 76.83% for PIEB, showing non-inferiority.
  • Additionally, other factors like pain scores at different times, medication consumption, and side effects were generally similar between the two methods, concluding that PIEB is an effective alternative for initial loading doses.
View Article and Find Full Text PDF

Exploration of the optimal programmed intermittent epidural bolus volume with the dural puncture epidural technique for labour analgesia: a biased-coin up-and-down sequential allocation study.

Can J Anaesth

October 2024

Department of Anesthesiology, Shanghai Key Laboratory of Maternal Fetal Medicine, Shanghai Institute of Maternal-Fetal Medicine and Gynecologic Oncology, Shanghai First Maternity and Infant Hospital, School of Medicine, Tongji University, Shanghai, China.

Purpose: To determine the optimal programmed intermittent epidural bolus (PIEB) volume for providing effective analgesia in 90% of patients (EV) during the first stage of labour using the dural puncture epidural (DPE) technique to initiate labour analgesia.

Methods: We conducted a biased-coin up-and-down sequential allocation study. We included 40 nulliparous women requiring epidural labour analgesia.

View Article and Find Full Text PDF

Want AI Summaries of new PubMed Abstracts delivered to your In-box?

Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!