title: Techniques for the maintenance of epidural labor analgesia.
abstract: OBJECTIVE
  After initiating neuraxial labor analgesia, there are many techniques that can be used to maintain analgesia for the duration of labor. In this review, we have examined the new techniques of maintenance of epidural labor analgesia recently proposed to overcome the undesirable effects of continuous infusion and patient-controlled epidural analgesia (PCEA).
  
  
  RESULTS
  As labor progresses, there is a greater need for analgesia. PCEA with basal infusion, automated intermittent mandatory boluses, programmed intermittent epidural boluses and computer-integrated PCEA have been introduced to combine the advantages of a manual bolus and continuous infusion, thus matching infusion rate and bolus modality to the patient's analgesic needs. Increased maternal satisfaction, reduced anesthetic consumption and decreased incidence of motor block are features of these new maintenance techniques.
  
  
  CONCLUSIONS
  Technology has now provided us with more advanced drug delivery systems that may have the potential to fulfill the maternal requirements of a safe, natural, and painless childbirth, tailoring the analgesic regimen for each parturient's need.
authors.affiliation: Department of Anesthesia, Città di Roma Hospital, Rome, Italy. dipartimento.anestesia@gruppogarofalo.com
authors.forename: Giorgio
authors.initials: G
authors.lastname: Capogna
authors.forename: Silvia
authors.initials: S
authors.lastname: Stirparo
mesh_terms: D000328:Adult; D015360:Analgesia, Epidural / Q000379:methods*; D016362:Analgesia, Obstetrical / Q000379:methods*; D016058:Analgesia, Patient-Controlled; D000700:Analgesics / Q000008:administration & dosage / Q000627:therapeutic use; D001331:Automation; D003201:Computers; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D048949:Labor Pain; D017060:Patient Satisfaction; D011247:Pregnancy
chemical_list: D000700:Analgesics