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ORIGINAL RESEARCH article

Front. Pharmacol.
Sec. Obstetric and Pediatric Pharmacology
Volume 15 - 2024 | doi: 10.3389/fphar.2024.1508514
This article is part of the Research Topic Patient Safety and Wellbeing in Obstetric Anesthesiology View all 5 articles

A randomized sequential allocation study on the optimum programmed intermittent epidural boluses interval time with different concentrations of ropivacaine combined with the dural puncture epidural technique for labor analgesia

Provisionally accepted
Jingjing Mao Jingjing Mao 1Yi Chen Yi Chen 2Linsen Sun Linsen Sun 1Xiaoxiao Xu Xiaoxiao Xu 1Kai Xu Kai Xu 1Tingting Ren Tingting Ren 1Xiangsheng Xiong Xiangsheng Xiong 1*Weibing Zhao Weibing Zhao 3
  • 1 Department of Anesthesiology, The Fifth People's Hospital of Huai'an, Huai’an, China
  • 2 Department of Anesthesiology and Perioperative Medicine, General Hospital of Ningxia Medical University, Yinchuan, China
  • 3 Yangzhou Institute of the Heart and Great Vessels (YIHGV), Yangzhou University, Yangzhou, China

The final, formatted version of the article will be published soon.

    The combined technique of programmed intermittent epidural boluses (PIEB) and dural puncture epidural (DPE) is currently considered a more effective mode for labor analgesia. We investigated the optimal interval time for PIEB administration with different concentrations of ropivacaine combined with the DPE for labor analgesia.Methods: Ninety patients with cervical dilation of < 5 cm and a VAS score > 5 were randomly assigned to receive labor analgesia with ropivacaine at concentrations of 0.075% (0.075% group), 0.1% (0.1% group), and 0.125% (0.125% group). In each group, an initial administration of a combination of ropivacaine 12 ml and sufentanil 0.3 µg/mL was followed by an additional dose of ropivacaine 10 ml and sufentanil 0.3 µg/mL after 30 minutes. The initial PIEB interval time was set at 40 minutes for the first patient in each group, and subsequent interval times for the following patients were adjusted based on meeting analgesic needs (VAS score ≤ 1) with a gradient of 10 minutes. The primary outcome was the ED90 of interval time required to achieve analgesic needs during PIEB with different concentrations of ropivacaine, employing an up-and-down sequential allocation method.The optimal PIEB interval times for ropivacaine concentrations of 0.075%, 0.1%, and 0.125% were determined to be 40.9 (95% CI, 45.3 (95% CI,), and 52.9 (95% CI, 46.8-59.3) minutes respectively, while comparable maternal and neonatal outcomes were observed across all groups.When PIEB is combined with DPE for labor analgesia, the optimal PIEB interval times for ropivacaine concentrations of 0.075%, 0.1%, and 0.125% were determined to be 41, 45, and 53 minutes respectively.

    Keywords: Interval time, programmed intermittent epidural boluses, Different concentrations, Ropivacaine, Dural puncture epidural

    Received: 09 Oct 2024; Accepted: 19 Dec 2024.

    Copyright: © 2024 Mao, Chen, Sun, Xu, Xu, Ren, Xiong and Zhao. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence: Xiangsheng Xiong, Department of Anesthesiology, The Fifth People's Hospital of Huai'an, Huai’an, China

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