A Retrospective Cohort Assessment of Labor Epidural Catheter Replacement With Programmed Intermittent Epidural Bolus and Continuous Epidural Infusion
Main finding · LEA catheter replacementResult — go to the resultOdds ratio 1.19 95% CI 0.90–1.56Authors' conclusion
LEA catheter replacement was more common with EPID than CSE, but not markedly different between CEI and PIEB. Clinician interventions to optimize analgesia were more common with CEI than with PIEB.
Study context
- Population
- Patients receiving labor epidural analgesia, July 1, 2013 – December 31, 2019
- Participants
- 13,177 / 2,182 / 4,082 / 11,277
- Exposure
- Programmed intermittent epidural boluses (PIEB) vs continuous epidural infusions (CEI) maintenance of labor epidural analgesia
- PIEBn = 13,177reference
- CEIn = 2,182
- Combined spinal epidural (CSE)n = 4,082reference
- Epidural (EPID)n = 11,277
- Outcome
- Catheter replacement
Methodological detailscombined pre-post and historical cohort, confounder-adjusted logistic and Cox regression
- Combined pre-post and historical cohort
- Confounder-adjusted logistic and Cox regression
Main finding
Labor epidural analgesia (LEA) catheter replacement
Odds ratio
1.19
95% CI 0.90–1.56
P = 0.21
CEI vs PIEB
OR 1.19 (95% CI 0.90–1.56); P = 0.21
As reported in the abstract
Observational data: associations, not effects.
Secondary outcomes
| Outcome | HR (95% CI) | P value | |
|---|---|---|---|
| Shorter time until catheter top-upCEI vs PIEB | 1.29 (1.14–1.46) | P < 0.001 | |
| 0.512Hazard ratio (log scale) |
| Outcome | Odds increase (95% CI) | P value |
|---|---|---|
| LEA catheter replacement, EPID vs CSE (secondary objective) | 1.28× (1.01–1.65) | P = 0.049 |
| At least 1 catheter top-upCEI vs PIEB | 1.34× (1.17–1.55) | P < 0.001 |
| Catheter intervention (composite)CEI vs PIEB | 1.34× (1.10–1.64) | P = 0.004 |
Original publication
A Retrospective Cohort Assessment of Labor Epidural Catheter Replacement With Programmed Intermittent Epidural Bolus and Continuous Epidural Infusion. Anesth Analg. Published 14 April 2026. doi:10.
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