Comparison of Continuous Epidural Infusion vs. Programmed Intermittent Epidural Bolus Combined With Patient-Controlled Epidural Analgesia for Labor Pain Relief: A Randomized Controlled Trial

What this Trial Is About

Researchers are evaluating two methods of epidural analgesia for relieving labor pain: Programmed Intermittent Epidural Bolus (PIEB) and Continuous Epidural Infusion (CEI), both combined with Patient-Controlled Epidural Analgesia (PCEA). This randomized controlled trial aims to compare how well each method controls pain while reducing anesthetic use and preserving maternal motor function. Sixty women in labor at Family Hospital, Da Nang, will be randomly assigned to either the PIEB or CEI group, and outcomes like pain levels, drug consumption, maternal satisfaction, and newborn Apgar scores will be assessed. All participants receive an initial manual epidural dose of 10 mL containing 0.1% Ropivacaine and 2 mcg/mL Fentanyl to start analgesia. The PIEB group then receives automated 8 mL boluses every hour, while the CEI group gets a continuous infusion at 8 mL per hour. Both groups can self-administer 5 mL boluses via PCEA with a 10-minute lockout and a maximum of 20 mL per hour. If pain remains high after two PCEA demands, a 5 mL rescue bolus is given by the anesthesia team. Participants will be monitored for pain intensity at multiple time points up to 4 hours after analgesia starts and during labor stages. Researchers will also measure total anesthetic consumption, maternal motor block incidence, maternal satisfaction, and newborn Apgar scores. Monitoring continues until perineal repair is complete, with assessments up to 24 hours after enrollment. The trial is scheduled to start in July 2025 and end in August 2026.

Comparing PIEB and CEI for Labor Pain Relief