Ferrer LE, et al. - A randomized controlled trial is conducted to evaluate both techniques and compare them with respect to labor analgesia and obstetric outcomes. This study evidenced a lower anesthetic intake in the programmed intermittent boluses group with similar labor analgesic control and obstetric and newborn outcomes in both groups.

Methods

• After Institutional Review Board approval, 132 laboring women aged between 18 and 45 years were randomized to epidural analgesia of 10 mL of a mixture of 0.1% bupivacaine plus 2 μg/mL of fentanyl either by programmed intermittent boluses or continuous infusion (66 per group).
• Primary outcome was the quality of analgesia.
• Secondary outcomes were the duration of labor, total drug dose used, maternal satisfaction, sensory level, motor block level, the presence of unilateral motor block, hemodynamics, side effects, mode of delivery, and newborn outcome.

Results

• Patients in the programmed intermittent epidural boluses group received statistically less drug dose than those with continuous epidural infusion (24.9 vs 34.4 mL bupivacaine; P = 0.01).
• No difference was seen between groups in regards to pain control, characteristics of block, hemodynamics, side effects, and Apgar scores.