Effectiveness of Programed Intermittent Epidural Bolus Interval 90 (EI90) of 10 ml, 0.0625% Bupivacaine Plus 2 μg/mL Fentanyl interval90(EI90)of10ml,0.0625%Bupivacaine Plus 2μg/mL Fentanyl

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    Menoufia University
Updated on 4 October 2022
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Multiple studies showed the numerous advantages of implementing programmed epidural bolus (PIEB) technique, where a fixed volume of local anesthetic is automatically administrated at a set time interval compared to the continuous epidural infusion technique (CEI). The advantages were improved maternal satisfaction, decreased local anesthetic consumption, and decreased second stage of labor.The theory behind PIEB is that to attain a more uniform spread of local anesthetic in the epidural space a higher volume of injectate and a higher pressure is needed.Different approaches using different timings and volumes for PIEB have been proposed to achieve the optimal regimen. Many studies showed evidence that 10 mL boluses of bupivacaine 0.0625% with fentanyl 2 μg/mL delivered every 40 min, named effective programed intermittent epidural bolus interval 90 (EI90), produced effective analgesia without breakthrough pain in 90% of nulliparous women during the first stage of labor.

Condition Labour Pain
Treatment programed intermittent epidural bolus interval 90 (EI90)
Clinical Study IdentifierNCT05441085
SponsorMenoufia University
Last Modified on4 October 2022


Yes No Not Sure

Inclusion Criteria

Patients of ASA physical status 2-3 with a singleton pregnancy
gestational age > 37 weeks
regular uterine contractions occurring at least every 5 min
cervical dilation 2-5 cm
pain > 5 (Visual analogue score (VAS) 0-10) at the time of request for epidural analgesia

Exclusion Criteria

Refusal to concent
Contraindication to epidural analgesia as allergy or hypersensitivity to bupivacaine or fentanyl
Patients who had opioids or sedatives within 4 h preceding epidural insertion
Unintentional dural puncture
Patient who deliver within 1 h after initiation of epidural clinician bolus
The inability to achieve as VAS score ≤2 after the initial loading dose will be considered as a failure and will be excluded from the study
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