Automated regular boluses for epidural analgesia: a comparison with continuous infusion

Lim, Yong Kuei; Sia, Alex Tiong Heng; Ocampo, Cecilia E.

doi:10.1016/j.ijoa.2005.05.004

Cited by 87 publications

(73 citation statements)

References 14 publications

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“…During the first three hours, median sensory block height to cold was higher and serial pain scores were lower among patients given intermittent boluses. Lim et al 5 demonstrated a reduced incidence of breakthrough pain requiring anesthesiologist-administered top-up when epidural analgesia was maintained using intermittent boluses of 5 mL every half hour as compared to a continuous infusion of 10 mL/h following induction of analgesia with intrathecal fentanyl 25 lg. However, unlike earlier studies, parturients in our current trial were able to supplement the degree of analgesia to their desired level using the PCEA.…”

Section: Discussionmentioning

confidence: 99%

“…3 Earlier studies have suggested that regular intermittent epidural boluses, as compared to a continuous epidural infusion, increase maternal satisfaction and decrease the incidence of breakthrough pain during the maintenance of labor epidural analgesia. [4][5][6] This may be attributed to a more extensive spread of epidural solution when delivered as a bolus rather than continuous infusion. 7 When incorporated into a PCEA regimen and used in place of a continuous basal infusion, automated intermittent boluses have been observed to reduce overall local anesthetic consumption without compromising analgesic efficacy.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

A randomized comparison of automated intermittent mandatory boluses with a basal infusion in combination with patient-controlled epidural analgesia for labor and delivery

Leo

Ocampo

Lim

et al. 2010

International Journal of Obstetric Anesthesia

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

A randomized comparison of automated intermittent mandatory boluses with a basal infusion in combination with patient-controlled epidural analgesia for labor and delivery

Leo

Ocampo

Lim

et al. 2010

International Journal of Obstetric Anesthesia

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“…It has been documented that PIEB is associated with less need for clinician intervention for inadequate pain control. There has been observed an increase in time to the first rescue bolus (5-7, 9, 10) and a lower number of manual boluses (5,11,12) in several studies. This has impact for both the parturient and the anesthesia work load.…”

mentioning

confidence: 98%

“…PIEB has gained considerable attention for the ability to improve patient satisfaction with their labor experience (6,11). The systematic review identified greater maternal satisfaction in the PIEB groups when evaluated by using a verbal rating scale (VRS) (4).…”

mentioning

confidence: 99%

Programmed Intermittent Epidural Boluses (PIEB): A Superior Technique for Maitenance of Labor Analgesia

Munro¹,

George²

2017

Turk J Anaesth Reanim

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“…20 Lim et al found lower incidence of breakthrough pain and higher maternal satisfaction in patients using automated regular bolus delivery of epidural analgesia when compared to continuous infusion. 21 Patient or physician controlled intermittent injections increases the workload compared to continuous infusion technique. We used intermittent epidural injection technique in our obstetric unit.…”

Section: Group 1 Group 2 Pmentioning

confidence: 99%

Comparison of Two Different Bupivacaine Doses with Sufentanil for Epidural Obstetric Analgesia

Çakirca¹,

Bektaş²,

Özcan³

et al. 2013

Turkiye Klinikleri J Med Sci

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A AB BS ST TR RA AC CT T OOb bj je ec ct ti iv ve e: : Addition of opioids to local anesthetics for epidural obstetric analgesia provides effective analgesia with decreased side effects. We compared the analgesic quality of 0,0625% bupivacaine and 0,1% bupivacaine with 0.5 μg/mL sufentanil. M Ma at te er ri ia al l a an nd d M Me et th ho od ds s: : Study participants were 18-45-year-old, primiparous 30 parturients. An epidural catheter was placed, 8-10 mL of 0.0625% bupivacaine with 0.5 μg/mL sufentanil and 0.1% bupivacaine with 0.5 μg/mL sufentanil were given to Group I and Group II, respectively. Hemodynamic parameters, obstetric examination findings, pain grades, time to reach visual analog scale (VAS)<4 and the first dose interval were recorded. Satisfaction levels, motor and sensorial blocks, oxytocin and valetamate bromide consumption, side effects were assessed. Total and additional drug use, duration of second stage of the delivery, mean delivery times, instrumental delivery, Apgar scores, fetal heart rates and uterine contraction pressures were recorded. The percentage of participation of the parturients to the delivery was assessed. R Re es su ul lt ts s: : Median VAS values were significantly lower in Group II. Median VAS values were lower than 4 in both groups after 15 th minute. The time to the second analgesic dose was longer in Group II. Systolic, diastolic and mean arterial blood pressures were measured lower in Group II. Satisfaction scores were significantly higher in Group II. C Co on nc cl lu us si io on n: : In the present study, satisfactory analgesia was produced in both groups. Although median VAS scores were lower in Group II, VAS<4 could be reached in Group I. We concluded that 0.0625% bupivacaine+0.5 μg/mL sufentanil combination, as providing VAS<4, could be a preferable alternative to 0.1% bupivacaine+0.5 μg/mL sufentanil. K Ke ey y W Wo or rd ds s: : Analgesia, obstetrical; analgesia, epidural Ö ÖZ ZE ET T A Am ma aç ç: : Epidural obstetrik analjezi için lokal anesteziklere opioidlerin eklenmesi daha efektif bir analjezi sağlar ve yan etkileri azaltır. Biz bu çalışmada %0,0625 bupivakain ve %0,1 bupivakaine 0,5 mikrog/mL sufentanil ekleyerek analjezi kalitesini karşılaştırdık. G Ge er re eç ç v ve e Y Yö ön nt te em ml le er r: : Çalışmaya, 18-45 yaşları arasında, 30 primipar gebe dahil edildi. Epidural kateter yerleştirildikten sonra %0,0625 bupivakain ile 0,5 mikrog/mL sufentanil veya %0,1 bupivakain ile 0,5 mikrog/mL sufentanil sırasıyla Grup I ve Grup II olarak belirlendi ve 8-10 mL uygulandı. Hemodinamik parametreler, obstetrik muayene bulguları, ağrı düzeyleri, vizuel analo skala (VAS)<4 olma zamanı ve ilk analjezik gereksinim zamanı kayıt edildi. Memnuniyet dereceleri, motor ve duyusal blok, oksitosin ve valetamat bromür kullanımı ve yan etkiler değerlendirildi. Toplam ve ek ilaç kullanımı, doğumun 2. evresinin süresi, doğumun toplam süresi, doğumda yardımcı alet kullanımı, Apgar skorları, fetal kalp hızı ve uterin kontraksiyon basınçları kayıt edildi. Gebelerin doğuma katılı...

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Automated regular boluses for epidural analgesia: a comparison with continuous infusion

Cited by 87 publications

References 14 publications

A randomized comparison of automated intermittent mandatory boluses with a basal infusion in combination with patient-controlled epidural analgesia for labor and delivery

A randomized comparison of automated intermittent mandatory boluses with a basal infusion in combination with patient-controlled epidural analgesia for labor and delivery

Programmed Intermittent Epidural Boluses (PIEB): A Superior Technique for Maitenance of Labor Analgesia

Comparison of Two Different Bupivacaine Doses with Sufentanil for Epidural Obstetric Analgesia

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