title: Epidural Analgesia for Labor: Continuous Infusion Versus Programmed Intermittent Bolus.
abstract: Despite the traditional practice to maintain labor analgesia with a combination of continuous epidural infusion and patient-controlled epidural analgesia using an automated epidural pump; compelling data now shows that bolus injection through the epidural catheter may result in better distribution of anesthetic solution in the epidural space. The programmed intermittent epidural bolus technique is proposed as a better maintenance mode and may represent a more effective mode of maintaining epidural analgesia for labor, especially prolonged labor. Additional prospective and adequately powered studies are needed to confirm findings and determine the optimal combination of volume, rate, time, and drug concentration.
authors.affiliation: Department of Anesthesiology and Critical Care, Perelman School of Medicine, Hospital of the University of Pennsylvania, 3400 Spruce Street, Dulles 6, Philadelphia, PA 19104, USA. Electronic address: Onyi.Onuoha@uphs.upenn.edu.
authors.forename: Onyi C
authors.initials: OC
authors.lastname: Onuoha
mesh_terms: D015360:Analgesia, Epidural / Q000379:methods*; D016058:Analgesia, Patient-Controlled; D000700:Analgesics / Q000008:administration & dosage*; D005260:Female; D006801:Humans; D007260:Infusion Pumps; D007743:Labor, Obstetric; D011247:Pregnancy
chemical_list: D000700:Analgesics
keywords: Automated pump; Combined-spinal epidural (CSE); Continuous epidural infusion (CEI); Epidural; Labor; Neuraxial analgesia; Patient-controlled epidural analgesia (PCEA); Programmed intermittent epidural bolus (PIEB)