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99 Programmed Intermittent Epidural Boluses (PIEB) for labor pain relief
  1. E Upryamova1,
  2. E Shifman2 and
  3. A Ovezov2
  1. 1Moscow Regional Scientific Research Institute of Obstetrics and Gynecology, Moscow, Russian Federation
  2. 2Moscow Regional Research and Clinical Institute (MONIKI), Moscow, Russian Federation


Background and Aims Epidural analgesia is the gold standard for the pain relief of labor.

The aim of this study was to compare the analgesic efficacy of PIEB technique and traditional techniques of epidural analgesia for labor pain relief.

Methods We studied 145 subjects. Term women with spontaneous labor and cervical dilation > 1–2cm were eligible to participate in the study. All parturients divided into 5 groups:

  1. manual boluses (levobupivacaine 0.25%–10.0 ml);

  2. PCEA (levobupivacaine 0.125% – 10.0 ml every 30’);

  3. CEI (0.125% – 10.0 ml/hour) + PCEA (levobupivacaine 0.125% – 10.0 ml every 30’);

  4. loading dose of levobupivacaine 0.125% – 10.0 ml, then CEI (0.0625% – 15 ml/hour) + PCEA (0.0625% – 10.0 ml every 20’);

  5. loading dose of levobupivacaine 0.125% – 10.0 ml, then PIEB (0.0625% – 9.0 ml every 45 ‘) + PCEA (0.0625% – 10.0 ml every 10’).

The effectiveness of labor analgesia was evaluated using VAS.

Results The analysis of the obtained data showed that the combined regimes of epidural analgesia (PCEA + CEI, PCEA + PIEB) provide a more consistent and effective analgesia of the first stage of labor than bolus techniques. However, the greatest average decrease in pain intensity in both I (p <0.00002) and II (p <0.0004) stages of was achieved in group 5 (PIEB) both in absolute and relative units.

Conclusions The PIEB technique with PCEA showed the greatest efficacy of pain relief during first and second stages of labor.

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