Programmed Intermittent Epidural Bolus versus Continuous Epidural Infusion in Major Upper Abdominal Surgery: A Retrospective Comparative Study

Kim, Yeon-Ju; Lee, Dokyeong; Kwon, Hyun-Jung; Kwon, Hye‐Mee; Lee, Jong-Hyuk; Kim, Doo-Hwan; Jeong, Seonghee

doi:10.3390/jcm10225382

Cited by 3 publications

(3 citation statements)

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“…Other studies using the PIEB technique have reported no significant difference compared to continuous infusion. [ 8 , 17 ] In this study, there was no significant difference in the required additional analysis within 48 hours after surgery, and there was no significant difference in the total dose and frequency of bolus injection of local anesthetic into the epidural space, but there was a difference in PONV. When the PIEB technique is applied, the infusion rate is increased, and the drug spreads to high levels in the epidural space, causing hypotension, which seems to be the cause of PONV.…”

Section: Discussionmentioning

confidence: 59%

Comparison of programmed intermittent epidural bolus injection and continuous epidural injection in controlling nighttime pain and improving sleep quality after thoracotomy

et al. 2022

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Background: Postoperative pain after open thoracotomy is known to be very severe and affects sleep quality. This study aimed to investigate the effects of a programmed intermittent epidural bolus injection versus continuous epidural injection for controlling nighttime pain and improving sleep quality after thoracotomy. Methods: Seventy-six patients scheduled for open thoracotomy for lung cancer or other lung diseases were enrolled. The participants were divided into 2 groups. Group A was continuously injected with 0.2% levobupivacaine at 1.1 mL/h, and group B was injected intermittently with 3 mL 0.2% levobupivacaine at 3 hours intervals through a thoracic epidural catheter via a programmed infusion pump. Within 48 hours after surgery, the degree of pain control using visual analog scale and the patients’ sleep conditions on postoperative day (POD) 0 and 1 were evaluated, and other adverse events were investigated. Results: On POD 1 night, the visual analog scale in group B showed lower than group A (P = .009). Comparison of time to fall asleep showed no differences between 2 groups. Total sleep time was no difference on POD 0 but was longer in group B than that in group A on POD 1 (P = .042). Awakening from sleep on POD 0 was lower in group B than that in group A (P = .033), and satisfaction with sleep quality on POD 0 was superior in group B compared to group A (P = .005). Postoperative nausea and vomiting occurred more frequently in group B than in group A (P = .018). Conclusion: The programmed intermittent epidural bolus technique of patient-controlled epidural analgesia reduces postoperative nighttime pain and improves sleep quality in patients undergoing thoracotomy for lung cancer or other lung diseases.

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Section: Discussionmentioning

confidence: 59%

Comparison of programmed intermittent epidural bolus injection and continuous epidural injection in controlling nighttime pain and improving sleep quality after thoracotomy

et al. 2022

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“…Programmed intermittent epidural bolus (PIEB) is a new way of injecting anesthetics into the epidural space through an epidural catheter at fixed time intervals. [1,2] It can be used as a background administration with the PCEA technique. [3] Although the use of a continuous epidural infusion (CEI) is gaining popularity, [4] it is unknown if the PIEB could improve the analgesic function.…”

Section: Introductionmentioning

confidence: 99%

“…The patient-controlled epidural analgesia (PCEA) technique has been recently set up as a preferred mode of epidural drug delivery and used widely. Programmed intermittent epidural bolus (PIEB) is a new way of injecting anesthetics into the epidural space through an epidural catheter at fixed time intervals [1,2] . It can be used as a background administration with the PCEA technique [3] .…”

Section: Introductionmentioning

confidence: 99%

Programmed intermittent epidural bolus in parturients

Wang

Zhang

et al. 2022

Medicine

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Background: To evaluate the efficacy and safety of programmed intermittent epidural bolus (PIEB) in parturients Methods: The PubMed, Embase, and the Cochrane Library (from inception to July 2021) were searched for identification of randomized placebo-controlled trials in which PIEB was applied in parturients. The outcomes were the effect of analgesia, satisfaction score, mode of delivery, duration of labor, neonatal condition, and adverse events. The pooled odds ratios (OR), weighted mean difference (WMD), and 95% confidence intervals (CIs) were calculated using random-and fixed-effects models.Results: PIEB was found to be associated with decreased total consumption of ropivacaine (WMD = À15.83, 95% CI: À19.06 to À12.60, P < .00001; I 2 = 61%; P for heterogeneity = .04), total consumption of sufentanil (WMD = À4.93, 95% CI: À6.87 to 2.98, P < .00001; I 2 = 68%; P for heterogeneity = .05), numbers of patients who require patient-controlled epidural analgesia bolus (OR = 0.27, 95% CI: 0.14-0.51, P < .0001; I 2 = 65%; P for heterogeneity = .01), the number of attempts (WMD = À4.12, 95% CI: À7.21 to À1.04, P = .009; I 2 = 100%; P for heterogeneity < .00001), rate of breakthrough pain (OR = 0.47, 95% CI: 0.28-0.80, P = .005; I 2 = 47%; P for heterogeneity = .09). Eight studies focus on the duration of analgesia. After by meta-analysis, we found that the pain visual analogue scale (VAS) score at 30 minutes, 2 hours, 4 hours, and 5 hours in PIEB group was significantly lower when compared with control group, (WMD = À0.15, 95% CI: À0.26 to À0.04, P = .006; I 2 = 0%; P for heterogeneity = .64), (WMD = À0.79, 95% CI: À1.32 to 0.25, P = .004; I 2 = 97%; P for heterogeneity < .00001), (WMD = À1.00, 95% CI: À1.08 to À0.91, P < .00001; I 2 = 0%; P for heterogeneity = .67), (WMD = À1.81, 95% CI: À3.23 to À0.39, P = .01; I 2 = 98%; P for heterogeneity < .00001), respectively. Nineteen studies discussed the mode of delivery between 2 groups. The results suggest that the rate of normal delivery is significantly higher in PIEB group compared with control group (OR = 1.37, 95% CI: 1.08-1.75, P = .01). The time of first and second stage of labor are significantly shorter in PIEB group compared with control group, the result is (WMD = À10.52, 95% CI: À14.74 to 4.76, P < .00001; I 2 = 0%; P for heterogeneity = .86), (WMD = À1.48, 95% CI: À2.26 to À0.69, P = .0002; I 2 = 35%; P for heterogeneity = .10), respectively. Thirteen studies concerned the satisfaction score of patients. The satisfaction score of patients in the PIEB group was significantly higher when compared with control group (WMD = 0.91, 95% CI: 0.42-1.39, P = .0003; I 2 = 98%; P for heterogeneity < .00001). The Apgar score at 1, 5 minutes in PIEB group are significantly higher (WMD = 0.07, 95% CI: 0.02-0.13 P = .007; I 2 = 55%; P for heterogeneity = .04), (WMD = À0.08, 95% CI: À0.12 to À0.05, P < .00001; I 2 = 21%; P for heterogeneity = .27), respectively.Conclusions: PIEB is a good alternative for labor analgesia with better analgesic effect, maternal and infant outcome.A...

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Perspective Chapter: Epidural Administration – Various Advances in Techniques

Fyneface-Ogan¹,

Ogan-Hart²

2023

Epidural Administration - New Perspectives and Uses

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First described by Fidel Pages in 1921, epidural administration is a technique in which a medicine is injected into the epidural space has undergone various modifications and approaches in recent years. Epidural administration also involves the placement of a catheter into the epidural space, which may remain in place for the duration of the treatment. These advances have changed the face of clinical practice and improved the patient management. Modification to the approach of epidural administration has moved from the single-shot epidural administration to programmed injections. The use of these improved techniques has reduced complications associated with epidural administration and improved care. The administration of medication into this space has been considered as safe and effective for providing pain relief during childbirth and surgery. A review of these modes of administration will highlight the importance of each of the techniques.

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Programmed Intermittent Epidural Bolus versus Continuous Epidural Infusion in Major Upper Abdominal Surgery: A Retrospective Comparative Study

Cited by 3 publications

References 32 publications

Comparison of programmed intermittent epidural bolus injection and continuous epidural injection in controlling nighttime pain and improving sleep quality after thoracotomy

Comparison of programmed intermittent epidural bolus injection and continuous epidural injection in controlling nighttime pain and improving sleep quality after thoracotomy

Programmed intermittent epidural bolus in parturients

Perspective Chapter: Epidural Administration – Various Advances in Techniques

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