Novel Labor Analgesic Technique: Computer-Controlled Dose-Needed Intermittent Epidural Drug Delivery without Opioid Supplementation

Epidural analgesia is the most effective technique to relieve labor pain. Much progress has been achieved in terms of providing more efficacious and safer labor analgesia. Maintenance regimens of labor analgesia have evolved from manual boluses to continuous infusions to patient-controlled boluses. Patientcontrolled epidural analgesia (PCEA) plus programmed intermittent epidural boluses (PIEB) regimens reduce local anesthetic consumption, decrease the need for clinician boluses and produced better analgesic efficacy and higher patient satisfaction in comparison with continuous epidural infusion (CEI). Sole epidural local anesthetic without opioid supplementation produced a comparable analgesic effect, lower local anesthetic consumption, fewer side effects, less incidence of neonatal lower Apgar scoring in comparison with local anesthetic plus opioid for labor analgesia. Computer-controlled dose-needed intermittent epidural drug delivery without opioid supplementation is a reliable and effective method of maintaining epidural labor analgesia.■