The mode of delivery of epidural solutions has progressed from clinician-delivered boluses, to automated continuous epidural infusions and the addition of patient-controlled epidural analgesia (PCEA), and now to programmed intermittent epidural boluses (PIEBs) in addition to PCEA. Currently, there is promising evidence for the use of combination PIEB and PCEA to minimize additional bolus requirements and reduce the amount of local anesthetic consumed, as well as improved patient satisfaction. There are few data regarding this mode of delivery in peripheral nerve catheters. The existing data in the peripheral nerve catheters do not show a clear advantage for the use of the programmed intermittent bolus (PIB) method. More studies are needed in various peripheral nerve/fascia plane blocks to answer this question. Studies looking at the median effective dose in 50% of patients of local anesthetics for labor epidurals (minimum local anesthetic concentration [MLAC]) have allowed the comparison of the relative potency of different local anesthetics. Even though the absolute numbers are not useful, we know that ropivacaine is only 60% as potent as bupivacaine for its analgesic potency and development of motor block, so it provides no advantage over bupivacaine for the labor epidural setting. MLAC studies have also allowed the study of adjuvants and their effect on labor analgesia. Fentanyl, epinephrine, and clonidine have been studied, showing significant local anesthetic–sparing effects. The risks and benefits of each adjuvant should be weighed for each patient, but fentanyl and epinephrine have an excellent benefit-to-risk ratio.