What’s New in Neuraxial Analgesia for Vaginal Delivery?

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Sasima Dusitkasem
Varunya Sermkasemsin
Amornrat Tangjitbampenbun


Epidural analgesia has been considered an effective and popular treatment for labor pain. Various settings for epidural maintenance including continuous epidural infusion (CEI) or patient-controlled epidural analgesia (PCEA) or both have been used in clinical practice. In recent years, a new mode, the programmed intermittent epidural bolus (PIEB) technique has been introduced. New data demonstrated that PIEB might reduce the use of anesthetic drugs, motor blockade, and improvements in maternal satisfaction compared with CEI. However, some studies show smaller impact and did not find clinical outcomes improvement with PIEB. The PIEB regimen and pump settings can influence the efficacy and potentially be the limitations of this technique.

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Review articles


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