The suggested mechanism of superior epidural analgesia with PIEB compared to CEI is greater spread of anesthetic solution within the epidural space, and therefore better sensory blockade compared to CEI.
All studies that have compared PIEB with CEI for labor epidural maintenance have found either better or equivalent analgesic and obstetric outcomes with PIEB.
Wong noted that there is currently no commercially available pump that delivers both PCEA and PIEB
Initial studies evaluating the PIEB technique used non-commercial programmed bolus devices or provided intermittent epidural boluses manually.
Several early studies found clinical advantages of PIEB when compared to CEI with and without PCEA for labor analgesia.
In the autumn of 2014, the IWK Health Centre implemented the CADD[R]-So-lis PIEB pumps to administer labor analgesia.
To provide labor analgesia using the CADD[R] PIEB pump there are several parameters that must be programmed into the epidural pump software.
We agree with the evidence comparing programmed intermittent epidural boluses (PIEB) to conventional continuous epidural infusions (CEI) for maintaining epidural labor analgesia presented by Munro and George, (1) showing advantages with PIEB for both the patient (with less local anesthetic consumption, improved maternal satisfaction, potentially shorter duration of labor) and the anesthesia team (with decreased workload requirements) (2).
So where does PIEB fit into these paradigms shifts and stepwise improvements?
Instituto de Investigaciones Antropologicas y Arqueologicas, Universidad Mayor de San Andres, PIEB
, ASDI-SAREC, La Paz.
5, Fundacion PIEB
, Editorial Offset Boliviana Ltda, La Paz.
Democracia representativa y liderazgos locales, PIEB
, La Paz.