Programmed Intermittent Epidural Bolus at Different Intervals Combined with Patient-controlled Epidural Analgesia on Body Temperature during Labour Analgesia

Abstract

Objective: To explore the effects of programmed intermittent epidural bolus (PIEB) combined with patient-controlled epidural analgesia (PCEA) at different intervals on body temperature and serum CRP, TNF-α, IL-6 levels in parturient women receiving analgesia.

Interventions for the prevention or treatment of epidural-related maternal fever: a systematic review and meta-analysis

“…An additional four records were identified by searching the grey literature, and one final record was obtained by correspondence with a trial author (P. Steer, personal communication, 2021). Thus, a total of 42 records 11 , 12 , 13 , 14 , 15 , 51 , 52 , 53 , 54 , 55 , 56 , 57 , 58 , 59 , 60 , 61 , 62 , 63 , 64 , 65 , 66 , 67 , 68 , 69 , 70 , 71 , 72 , 73 , 74 , 75 , 76 , 77 , 78 , 79 , 80 , 81 , 82 , 83 , 84 , 85 , 86 , 87 – representing 34 studies and including a total 10 221 participants – are included in the review.…”

“…Thirteen studies evaluated various methods of reducing epidural dose: intermittent administration, 11 , 12 , 80 lower dose formulations, 56 , 67 , 83 automated bolus regimens, 66 , 68 , 73 , 74 delayed administration, 71 reduced rate administration, 52 or local anaesthetic only with no spinal analgesia component. 72 Eight compared alternative methods of analgesia, 54 , 57 , 60 , 64 , 69 , 77 , 78 , 82 one evaluated additional epidural opioid, 65 two trials evaluated either warming the epidural solution 59 or using a heated neck warmer, 74 and two trials evaluated methods of acupuncture. 51 , 55 Three trials evaluated steroid 13 , 85 , 87 prophylaxis, two trials evaluated paracetamol 14 , 58 prophylaxis, and one trial evaluated antibiotic 15 prophylaxis.…”

“…The comparator in 24 of the 34 studies was an active control arm. This was either a different dose, 56 , 67 , 84 drug, 54 , 57 , 60 , 64 , 65 , 69 , 78 , 79 or administration process 11 , 12 , 52 , 59 , 61 , 66 , 68 , 71 , 75 , 82 to the trial intervention. In four trials all participants received the same epidural analgesia and an additional trial intervention that had no active comparator.…”

“… 54 , 60 , 61 , 74 Twenty-one trials concealed the allocation sequence until participants were assigned to intervention by using sequentially numbered, opaque, sealed envelopes, and two trials 13 , 15 reported using identical preparations of the study drugs. Ten trials did not provide any information on allocation concealment 11 , 14 , 51 , 52 , 54 , 56 , 60 , 74 , 82 , 83 and one trial stated that allocation was not concealed at all. 57 Twenty trials stated that participants were blinded.…”

“… 12 , 13 , 14 , 15 , 52 , 56 , 59 , 66 , 67 , 68 , 72 , 73 , 75 , 76 , 78 , 83 , 84 , 85 , 86 , 87 The clinical teams and clinicians delivering the intervention were blinded in 15. 12 , 13 , 52 , 56 , 58 , 59 , 67 , 68 , 72 , 76 , 83 , 84 , 85 , 87 It was unclear whether participants and clinical teams were blinded in one 82 and six 14 , 15 , 66 , 75 , 78 , 82 trials, respectively. In the remaining 13 trials, all participants and clinical teams were aware of the assigned intervention groups.…”