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Effect of programmed intermittent epidural boluses and continuous epidural infusion on labor analgesia and obstetric outcomes: a randomized controlled trial

  • Maternal-Fetal Medicine
  • Published:
Archives of Gynecology and Obstetrics Aims and scope Submit manuscript

Abstract

Purpose

Continuous epidural infusion and programmed intermittent epidural boluses are analgesic techniques routinely used for pain relief in laboring women. We aimed to assess both techniques and compare them with respect to labor analgesia and obstetric outcomes.

Methods

After Institutional Review Board approval, 132 laboring women aged between 18 and 45 years were randomized to epidural analgesia of 10 mL of a mixture of 0.1% bupivacaine plus 2 µg/mL of fentanyl either by programmed intermittent boluses or continuous infusion (66 per group). Primary outcome was quality of analgesia. Secondary outcomes were duration of labor, total drug dose used, maternal satisfaction, sensory level, motor block level, presence of unilateral motor block, hemodynamics, side effects, mode of delivery, and newborn outcome.

Results

Patients in the programmed intermittent epidural boluses group received statistically less drug dose than those with continuous epidural infusion (24.9 vs 34.4 mL bupivacaine; P = 0.01). There was no difference between groups regarding pain control, characteristics of block, hemodynamics, side effects, and Apgar scores.

Conclusions

Our study evidenced a lower anesthetic consumption in the programmed intermittent boluses group with similar labor analgesic control, and obstetric and newborn outcomes in both groups.

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Author information

Authors and Affiliations

  1. Department of Anesthesiology, Hospital Fundación Santa Fe de Bogotá, Carrera 7 No. 117-15, Bogotá, Colombia

    Leopoldo E. Ferrer, David J. Romero, Oscar I. Vásquez & Ednna C. Matute

  2. Department of Anesthesiology, University Hospitals Gasthuisberg, Katholieke Universiteit Leuven, Oude Markt 13, 3000, Louvain, Belgium

    Marc Van de Velde

Authors
  1. Leopoldo E. Ferrer
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  2. David J. Romero
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  3. Oscar I. Vásquez
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  4. Ednna C. Matute
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  5. Marc Van de Velde
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Contributions

LE Ferrer: Project development, data analysis, manuscript editing. DJ Romero: Protocol development, data collection, manuscript writing. OI Vásquez: Protocol development, data collection, manuscript writing. EC Matute: Project development, data analysis, manuscript editing. M Van de Velde: Data analysis, manuscript editing.

Corresponding author

Correspondence to Leopoldo E. Ferrer.

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Conflict of interest statement

The authors declare that they have no conflict of interest.

Research involving human participants and/or animals

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. This article does not contain any studies with animals performed by any of the authors.

Informed consent

Informed consent was obtained from all individual participants included in the study.

Declaration of funding

This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.

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Ferrer, L.E., Romero, D.J., Vásquez, O.I. et al. Effect of programmed intermittent epidural boluses and continuous epidural infusion on labor analgesia and obstetric outcomes: a randomized controlled trial. Arch Gynecol Obstet 296, 915–922 (2017). https://doi.org/10.1007/s00404-017-4510-x

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  • DOI: https://doi.org/10.1007/s00404-017-4510-x

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