Comparing Programmed Intermittent Epidural Bolus and Continuous Epidural Infusion for Pain Relief in Multiparous Women During Labor

What this Trial Is About

This research aims to evaluate how programmed intermittent bolus epidural analgesia affects the occurrence of breakthrough pain during labor in women who have given birth before. The study compares this method to continuous epidural infusion, focusing on pain relief and labor outcomes. Epidural analgesia is a widely used method for labor pain relief, and this trial explores whether programmed bolus dosing combined with patient-controlled analgesia reduces breakthrough pain and improves satisfaction compared to continuous infusion methods. Participants are randomly assigned to one of two groups during labor. The study group receives a programmed intermittent bolus of 10 ml of 0.1% Bupivacaine with 2 microgramsml Fentanyl every hour, while the control group receives a continuous infusion of the same medication and dose. Both groups can self-administer additional boluses of 5 ml every 30 minutes, up to a maximum of 20 ml per hour. Treatment continues until delivery and suturing of any lacerations. Women in the study will be closely monitored for pain levels using a visual analogue scale and for any breakthrough pain episodes. Researchers will assess a variety of outcomes including pain scores, labor duration, mode of delivery, medication consumption, maternal satisfaction, and newborn health indicators within 48 hours after delivery. Safety and side effects related to epidural analgesia will also be recorded, with follow-up extending up to 96 hours for some measures.

Programmed Intermittent Epidural Bolus Compared With Continuous Infusion in Multiparous Women