PIEBProgrammed Intermittent Epidural Bolus
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But we have still have some questions: What are the main advantages of PIEB compared to other techniques (e.g.
Wong and her colleagues reported that the currently available pumps used for patient-controlled epidural anesthesia (PCEA) also can be programmed to automatically deliver boluses at regular intervals, and that this "programmed intermittent epidural bolus" (PIEB) resulted in similar analgesia but with a smaller bupivacaine dose and better patient satisfaction, compared with continuous epidural infusion (CEI) for maintenance of epidural labor analgesia (Anesth.
The evolution of maintenance of epidural analgesia has progressed from manually delivered intermittent boluses to continuous epidural infusion (CEI), to the addition of patient-controlled epidural analgesia (PCEA) boluses for breakthrough pain and now programmed intermittent epidural bolus (PIEB).
The advantages of Programmed Intermittent Epidural Bolus (PIEB) for the maintenance of labor analgesia have been clearly established.
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).