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Upryamova E.Yu.

Moscow Regional Research Institute of Obstetrics and Gynecology

Shifman E.M.

Moscow Regional Research and Clinical Institute

Krasnopolskiy V.I.

Moscow Regional Research Institute of Obstetrics and Gynecology

Ovezov A.M.

Moscow Regional Research and Clinical Institute

Programmed intermittent epidural boluses for labor analgesia: influence on obstetric and anesthetic outcomes (results of a prospective single-center randomized controlled clinical trial)

Authors:

Upryamova E.Yu., Shifman E.M., Krasnopolskiy V.I., Ovezov A.M.

More about the authors

Journal: Russian Bulletin of Obstetrician-Gynecologist. 2021;21(5): 49‑58

DOI: 10.17116/rosakush20212105149

Read: 1101 times

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Table of contents

PROGRAMMED INTERMITTENT EPIDURAL BOLUSES FOR LABOR ANALGESIA: INFLUENCE ON OBSTETRIC AND ANESTHETIC OUTCOMES (RESULTS OF A PROSPECTIVE SINGLE-CENTER RANDOMIZED CONTROLLED CLINICAL TRIAL)
PROGRAMMED INTERMITTENT EPIDURAL BOLUSES FOR LABOR ANALGESIA: INFLUENCE ON OBSTETRIC AND ANESTHETIC OUTCOMES (RESULTS OF A PROSPECTIVE SINGLE-CENTER RANDOMIZED CONTROLLED CLINICAL TRIAL)

To cite this article:

Upryamova EYu, Shifman EM, Krasnopolskiy VI, Ovezov AM. Programmed intermittent epidural boluses for labor analgesia: influence on obstetric and anesthetic outcomes (results of a prospective single-center randomized controlled clinical trial). Russian Bulletin of Obstetrician-Gynecologist. 2021;21(5):49‑58. (In Russ.)
https://doi.org/10.17116/rosakush20212105149

Подписка 2026 Российский вестник акушера-гинеколога (Russian Bulletin of Obstetrician-Gynecologist)
МСФ на ЯМ
Использование инфографики авторами научных работ
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In memory of prominent soviet obstetricians and gyne­cologists — professors V.Ya. Ilke­vich (1872—1939), M.S. Naidich (1883—1963) and V.G. Butomo (1894—1963). Russian Bulletin of Obstetrician-Gynecologist. 2025;(2):105-110
Abstract:

BACKGROUND

The PIEB technique is a promising approach that demonstrates certain advantages over traditional techniques epidural analgesia.

OBJECTIVE

To compare the effect of the PIEB on obstetric and anesthetic outcomes in women in labor with traditional methods of epidural analgesia (bolus, PCEA, CEI + PCEA).

MATERIAL AND METHODS

A prospective study evaluating the anesthetic outcomes by using various epidural analgesia was studied in 175 women in labor. All women were divided into 5 groups depending on administration and concentration of local anesthetic: group 1 (n=35) — manual boluses up to request (levobupivacaine 0.25% — 10.0 ml); group 2 (n=35) — PCEA (levobupivacaine 0.125% — 10.0 ml every 30’); group 3 (n=35) — CEI (0.125% — 10.0 ml/hour) + PCEA (levobupivacaine 0.125% — 10.0 ml every 30’); gropu 4 (n=35) — loading dose of levobupivacaine 0.125% — 10.0 ml, then CEI (0.0625% — 15 ml/hour) + PCEA (0.0625% — 10.0 ml every 20’); group 5 (n=35) — loading dose of levobupivacaine 0.125% — 10.0 ml, then PIEB (0.0625% — 9.0 ml every 45 ‘) + PCEA (0.0625% — 10.0 ml every 10’).

RESULTS

The results of distributions’ comparison between studied groups show a statistically significant difference in mean values for the duration of labor second stage. The duration of labor second stage is especially prominent in the group 1, which statistically calculated indicators were significantly longer than in the other groups. The blood loss volume, the frequency of cesarean section (CS) and fetal vacuum extraction did not achieve a statistically significant difference between the groups (p>0.05). The total amount of local anesthetic had a statistically significant difference in mean values between groups. The most compact range of values is observed in the group 2; the largest range is noted in the group 3.

CONCLUSIONS

The combination of PIEB + PCEA epidural regimen with a low concentration of local anesthetic (0.625 mg/ml levobupivacaine) is the most optimal strategy to improve obstetric outcomes and reduce maternal side effects (minimization of motor block, verticalization) without compromising the quality of analgesia.

Keywords:

programmed intermittent epidural bolus
levobupivacaine
labor pain relief
obstetric and anesthetic outcomes

Authors:

Upryamova E.Yu.

Moscow Regional Research Institute of Obstetrics and Gynecology

Shifman E.M.

Moscow Regional Research and Clinical Institute

Krasnopolskiy V.I.

Moscow Regional Research Institute of Obstetrics and Gynecology

Ovezov A.M.

Moscow Regional Research and Clinical Institute

Received:

07.02.2021

Accepted:

07.04.2021

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References:

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