A Comparative Study of Sequential Epidural Bolus Technique and Continuous Epidural Infusion

Ueda, K.; Ueda, Wasa; Manabe, Masanobu

doi:10.1097/00000542-200507000-00019

Cited by 48 publications

(26 citation statements)

References 11 publications

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“…This new method reduced the amount of medication and provided better pain relief than a continuous epidural infusion. [22][23][24] In patients who received postoperative thoracic epidural analgesia, Ueda et al 21 found that programmed epidural bolus administration of local anesthetic resulted in more anesthetized spinal segments compared with a continuous infusion. Experimentally, the use of intermittent bolus doses resulted in a wider spread of solution when compared with a continuous infusion, despite a similar infusion rate.…”

Section: Discussionmentioning

confidence: 99%

“…3,14 -20 A new dosing regimen of automated bolus administration has been described for epidural analgesia with excellent results. [21][22][23][24] However, no information is currently available using this dosing regimen for continuous peripheral nerve blocks. The objective of this prospective, randomized, double-blind study was to compare two different dosing regimens: a conventional continuous infusion of local anesthetic with automated bolus doses and their impact on pain relief and IV analgesic requirements in patients undergoing continuous popliteal sciatic nerve blockade for postoperative analgesia.…”

mentioning

confidence: 99%

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A “New” Automated Bolus Technique for Continuous Popliteal Block: A Prospective, Randomized Comparison with a Continuous Infusion Technique

Taboada¹,

Rodríguez²,

Bermúdez³

et al. 2008

Anesthesia &Amp; Analgesia

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Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

A “New” Automated Bolus Technique for Continuous Popliteal Block: A Prospective, Randomized Comparison with a Continuous Infusion Technique

Taboada¹,

Rodríguez²,

Bermúdez³

et al. 2008

Anesthesia &Amp; Analgesia

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“…Programmed intermittent bolus infusion (PIBI) and continuous infusion (CI) are commonly used methods of continuous nerve block for postoperative patient-controlled analgesia (PCA). It has been demonstrated that sequential epidural boluses improve the quality of sensory blockade as compared with a continuous epidural block 6. Similarly, Taboada et al found that local anesthetic administered during a continuous popliteal block as a programmed bolus provided similar pain relief, and reduced the need for PCA, as well as demonstrating a decrease in overall consumption of local anesthetic 7.…”

Section: Introductionmentioning

confidence: 98%

Comparison of programmed intermittent bolus infusion and continuous infusion for postoperative patient-controlled analgesia with thoracic paravertebral block catheter: a randomized, double-blind, controlled trial

Chen

Cai

et al. 2019

Regional Anesthesia &Amp; Pain Medicine

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Background and objectivesIn this randomized, double-blind, controlled study, we hypothesized that programmed intermittent bolus infusion (PIBI) of local anesthetic for continuous paravertebral block (PVB), combined with patient-controlled analgesia (PCA), provided better pain control, better patient satisfaction, and decreased in local anesthetic consumption when compared with a continuous infusion (CI) combined with PCA, after video-assisted thoracoscopic unilateral lung resection surgery.MethodsPreoperatively, patients undergoing video-assisted thoracoscopic unilateral lung resection surgery received ipsilateral paravertebral catheters inserted at the level of thoracic vertebrae 4 and 5. All the subjects received an initial bolus of 15 mL 0.375% ropivacaine via the catheters. Subjects were randomized to receive 0.2 % ropivacaine 8 mL/h as either PIBI (n=17) or CI (n=17) combined with a PCA pump. The pain scores, frequency of PCA, local anesthetic consumption, patient satisfaction, and the need for rescue analgesia with tramadol were recorded until 48 hours postoperative.ResultsThe numeric rating scale scores in the PIBI group were significantly lower than the CI group at 4, 8, 12 hours and 4, 8, 12, 24 hours postoperatively, at rest, and during coughing, respectively. PCA local anesthetic consumption (30 mg (20–60 mg) vs 120 mg (70–155 mg), p=0.000) and frequency of PCA use over 48 hours (3 (2–6) vs 12 (7–15.5), p=0.000) was lower in the PIBI group as compared with the CI group. Additionally, the PIBI group showed greater patient satisfaction. The need for tramadol rescue was similar in the two groups.ConclusionsIn PVBs, local anesthetic administered as a PIBI in conjunction with PCA provided superior postoperative analgesia to a CI combined with PCA in patients undergoing video-assisted thoracoscopic unilateral lung resection surgery.Clinical trial registrationChiCTR-IOR-17011253.

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“…Yokoyama et al 8 and Ueda et al 9 However, the phenomenon may also be considered inversely: epidural continuous infusion without an initial dose may spread the requisite extent of F i g . 1 B a r g r a p h a n d b o x p l o t o f t h e f r e q u e n c y o f f l u r b i p r o f e n a x e t i l u s e .…”

Section: Discussionmentioning

confidence: 99%

An Epidural Initial Dose is Unnecessary in Combined Spinal Epidural Anesthesia for Caesarean Section

et al. 2006

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Combined spinal epidural anesthesia is widely used for Caesarean section. Bolus administration of an epidural initial dose introduces the risk of drug flux from the epidural space to the subarachnoid space, and the volume effect of the initial dose may cause epidural top-up and extension of subarachnoid blockade. These problems may be avoided if the initial dose is not administered. This study investigated whether epidural continuous infusion without an initial dose (continuous group) can decrease postoperative pain as well as an epidural continuous infusion with an initial dose (initial dose group). Sixty-one patients undergoing elective Caesarean section were randomly assigned to the initial dose group or the continuous group. Twenty patients undergoing emergency Caesarean section with spinal anesthesia (spinal group) were also investigated to confirm that epidural block is effective for postoperative pain. Data in this study were obtained retrospectively from each patient!s records. Between the initial dose group and the continuous group, there was no significant difference in the number of times flurbiprofen or pentazocine were used for postoperative pain relief. However, the number of times that pentazocine was used was significantly higher in the spinal group than in other groups. This finding suggests that an epidural initial dose is unnecessary for postoperative pain relief in combined spinal epidural anesthesia for Caesarean section. (J Nippon Med Sch 2006; 73: 70!74)

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A Comparative Study of Sequential Epidural Bolus Technique and Continuous Epidural Infusion

Abstract: The SEB technique with ropivacaine provides superior epidural block compared with an identical hourly dose administered as a continuous infusion.

Cited by 48 publications

References 11 publications

A “New” Automated Bolus Technique for Continuous Popliteal Block: A Prospective, Randomized Comparison with a Continuous Infusion Technique

A “New” Automated Bolus Technique for Continuous Popliteal Block: A Prospective, Randomized Comparison with a Continuous Infusion Technique

Comparison of programmed intermittent bolus infusion and continuous infusion for postoperative patient-controlled analgesia with thoracic paravertebral block catheter: a randomized, double-blind, controlled trial

An Epidural Initial Dose is Unnecessary in Combined Spinal Epidural Anesthesia for Caesarean Section

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