Determination of the Optimal Volume of Programmed Intermittent Epidural Bolus When Combined With the Dural Puncture Epidural Technique for Labor Analgesia: A Random-Allocation Graded Dose-Response Study
Authors' conclusion
Under the conditions of the study, after initiation of analgesia using DPE, the EV90 of PIEB for effective labor analgesia using ropivacaine 0.1% with sufentanil 0.5 μg/mL was approximately 11.3 mL.
Study context
- Population
- Parturients requesting labor analgesia, initiated by dural puncture epidural (DPE) (25-gauge Whitacre) with 15 mL ropivacaine 0.1% + sufentanil 0.5 μg/mL; Programmed intermittent epidural bolus (PIEB) every 40 minutes
- Comparison
- PIEB volumes of 6, 8, 10 or 12 mL after DPE initiation
- Primary endpoint
- Effective analgesia (no patient-controlled or manual epidural bolus required); EV50 and EV90 of PIEB volume
- Follow-up
- 6 hours after completion of initial epidural dose or until full cervical dilation
Methodological detailsrandom-allocation, graded dose-response, probit regression
- Random-allocation
- Graded dose-response
- Probit regression
Primary result
As reported in the abstract
Effective labor analgesia
- EV50 7.1 mL
- 7.1 (95% CI 5.9-7.9)
- EV90 11.3 mL
- 11.3 (95% CI 9.9-15.2)
Safety
Side effects (hypotension, nausea and vomiting, fetal heart rate (FHR) abnormalities)
- No differences among groups
Original publication
Determination of the Optimal Volume of Programmed Intermittent Epidural Bolus When Combined With the Dural Puncture Epidural Technique for Labor Analgesia: A Random-Allocation Graded Dose-Response Study. Anesth Analg. Published 3 April 2023. doi:10.
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