2. #PIEBepidural@Ron_George CAS 2017@Ron_George #AnesGR
Learning Objectives
1. Describe the current knowledge regarding
PIEB impact on analgesia & obstetrical
outcomes
2. Demonstrate the limitations in evidence for
PIEB for labour analgesia
3. Describe implementation strategies for PIEB to
optimize effective and safe utilization on your
labour units
4. Discuss future considerations for PIEB and
labour analgesia
38. #AnesGR@Ron_George
Meta-analysis comparing PIEB and CEI +/- PCEA
for Labor Analgesia
Local anesthetic consumption –1.2 mg/h (95% CI, –2.2 to –0.3) 0.01
Maternal satisfaction scores 7.0 mm (95% CI, 6.20 to 7.8) <0.00001
Duration of 2nd stage of labor –12 min (95% CI, –23 to 0) 0.04
Mode of delivery
Cesarean delivery 0.87 (95% CI, 0.56 to 1.35) 0.54
Instrumented delivery 0.59 (95% CI, 0.35 to 1.00) 0.05
Total duration of labor –12 min (95% CI, –23 to 0) 0.04
Anesthesia interventions 0.56 (95% CI, 0.29 to 1.06) 0.08
47. #AnesGR@Ron_George
The optimal time interval between
PIEB of 10 mL of bupivacaine 0.0625%
with fentanyl 2 μg/mL is approximately
40 minutes
42.6 minutes (95% CI 38.9–46.4)
51. #PIEBepidural@Ron_George CAS 2017@Ron_George #AnesGR
Labor Epidural
PIEB + PCEA
Ropivacaine + fentanyl
PIEB Bolus
PIEB Interval
PCEA Bolus
PCEA Lockout
NEXT Bolus
8 ml
45 min
6 ml
10 min
15 min