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Clinical Research Article
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DOI: https://doi.org/10.4097/kja.23726
- Comparison of analgesic effects between programmed intermittent epidural boluses and continuous epidural infusion after cesarean section: a randomized controlled study
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Yu Jeong Bang1
, Heejoon Jeong1
, RyungA Kang1
, Ji-Hee Sung2
, Suk-Joo Choi2
, Soo-Young Oh2
, Tae Soo Hahm1
, Young Hee Shin1
, Yeon Woo Jeong1
, Soo Joo Choi1
, Justin Sangwook Ko1
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1Department of Anesthesiology and Pain Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
2Department of Obstetrics and Gynecology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
- Corresponding author: RyungA Kang ,Tel: +82-2-3410-2463, Fax: +82-2-3410-0361, Email: ryunga.kang@samsung.com
- Received: October 5, 2023; Revised: March 14, 2024 Accepted: March 14, 2024.
- Abstract
- Background
This study aimed to compare the analgesic effects of programmed intermittent epidural boluses (PIEB) and continuous epidural infusion (CEI) for postoperative analgesia after elective cesarean section (CS).
Methods
Seventy-four women who underwent elective CS were randomized to receive either PIEB or CEI. The PIEB group received 4 ml-intermittent boluses of 0.11% ropivacaine every hour at a rate of 120 ml/h. The CEI group received a constant rate of 4 ml/h of 0.11% ropivacaine. The primary outcome was the pain score at rest at 36 h after CS. Secondary outcomes included the pain scores during mobilization, time-weighted pain scores, the incidence of motor blockade, and complications-related epidural analgesia during 36 h after CS.
Results
The pain score at rest at 36 h after CS was significantly lower in the PIEB group compared with that in the CEI group (3.0 vs. 0.0; median difference, 2; 95% CI: 1, 2; P < 0.001). The mean time-weighted pain scores at rest and during mobilizations were also significantly lower in the PIEB group than in the CEI group (pain at rest: mean differences, 37.5; 95% CI, [24.6, 50.4]; P < 0.001; pain during mobilization: mean difference, 56.6; 95% CI, [39.8, 73.5]; P < 0.001). The incidence of motor blockade was significantly reduced in the PIEB group compared with that in the CEI group (P < 0.001).
Conclusion
PIEB provides superior analgesia with less motor blockade than CEI in postpartum women after CS, without any apparent adverse events.
Keywords :Cesarean section; Epidural analgesia; Programmed intermittent epidural boluses; Continuous epidural infusion; Postoperative pain; Motor blockade
