Programmed intermittent epidural bolus in maintenance of epidural labor analgesia: a literature review

Programmed intermittent epidural bolus (PIEB), administered by the infusion pump programmed to deliver boluses of epidural solution at certain intervals, is gradually gaining more attention as a technique to maintain the labor analgesia in recent years. Many studies find that it may have some advantages when compared with other methods. However, its exact effectiveness and optimal regimen are still unclear. We conducted a literature search in PubMed, Web of Science, and Cochrane Database of Systematic Reviews for studies published between January 2010 and June 2022. Of the 263 publications identified, 27 studies were included. The purpose of this review is to discuss the effects of PIEB with continuous epidural infusion (CEI) and patient-controlled epidural analgesia (PCEA) in maintenance of epidural labor analgesia on labor outcomes and elucidate the latest research progress of implementation strategies.

Automated summary

Programmed intermittent epidural bolus (PIEB) is a technique that delivers boluses of epidural solution at certain intervals, and it has been gaining attention as a method to maintain labor analgesia. This review aims to discuss the effects of PIEB in combination with continuous epidural infusion (CEI) and patient-controlled epidural analgesia (PCEA) on labor outcomes and provide an update on the latest research progress in implementation strategies. A literature search was conducted, and 27 studies published between January 2010 and June 2022 were included in the review.