Direct Comparison of Peak Bulk Flow Rate of Programmable Intermittent Epidural Bolus and Manual Epidural Bolus Using a Closed-End Multiorifice Catheter: An Experimental Study

Abstract

(Anesth Analg. 2023;136:1198–1205) Labor analgesia is a popular and widespread technique for pain management during labor and delivery, with many facilities adopting an administration method of programmable intermittent epidural bolus (PIEB). Previous research has studied both advantages and disadvantages of PIEB, with a consensus that advantages outweigh disadvantages. Many institutions also give access to a manual epidural bolus for breakthrough pain and/or for underperforming epidural analgesia, and studies have shown that this combination tends to lead to greater patient satisfaction, greater sensory blockade and improved pain control. Though studies have analyzed the effects of these methods, knowledge is lacking for the comparison of flow rate between PIEB and manual bolus. Understanding any differences could be beneficial to current understanding of mechanisms of pain management during labor and delivery.