Comparison of analgesic effects between programmed intermittent epidural boluses and continuous epidural infusion after cesarean section: a randomized controlled study
- Author:
Yu Jeong BANG
1
;
Heejoon JEONG
;
RyungA KANG
;
Ji-Hee SUNG
;
Suk-Joo CHOI
;
Soo-Young OH
;
Tae Soo HAHM
;
Young Hee SHIN
;
Yeon Woo JEONG
;
Soo Joo CHOI
;
Justin Sangwook KO
Author Information
- Publication Type:Clinical Research Article
- From:Korean Journal of Anesthesiology 2024;77(3):374-383
- CountryRepublic of Korea
- Language:EN
-
Abstract:
Background:This study aimed to compare the analgesic effects of programmed intermittent epidural boluses (PIEB) and continuous epidural infusion (CEI) for postoperative analgesia after elective cesarean section (CS).
Methods:Seventy-four women who underwent elective CS were randomized to receive either PIEB or CEI. The PIEB group received 4 ml-intermittent boluses of 0.11% ropivacaine every hour at a rate of 120 ml/h. The CEI group received a constant rate of 4 ml/h of 0.11% ropivacaine. The primary outcome was the pain score at rest at 36 h after CS. Secondary outcomes included the pain scores during mobilization, time-weighted pain scores, the incidence of motor blockade, and complications-related epidural analgesia during 36 h after CS.
Results:The pain score at rest at 36 h after CS was significantly lower in the PIEB group compared with that in the CEI group (3.0 vs. 0.0; median difference: 2, 95% CI [1, 2], P < 0.001). The mean time-weighted pain scores at rest and during mobilizations were also significantly lower in the PIEB group than in the CEI group (pain at rest; mean difference [MD]: 37.5, 95% CI [24.6, 50.4], P < 0.001/pain during mobilization; MD: 56.6, 95% CI [39.8, 73.5], P < 0.001). The incidence of motor blockade was significantly reduced in the PIEB group compared with that in the CEI group (P < 0.001).
Conclusions:PIEB provides superior analgesia with less motor blockade than CEI in postpartum women after CS, without any apparent adverse events.
