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
BackgroundThe 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 comb...
Saved in:
| Main Authors: | , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Frontiers Media S.A.
2025-01-01
|
| Series: | Frontiers in Pharmacology |
| Subjects: | |
| Online Access: | https://www.frontiersin.org/articles/10.3389/fphar.2024.1508514/full |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1841556726700048384 |
|---|---|
| author | Jingjing Mao Yi Chen Linsen Sun Xiaoxiao Xu Kai Xu Tingting Ren Xiangsheng Xiong Weibing Zhao Weibing Zhao |
| author_facet | Jingjing Mao Yi Chen Linsen Sun Xiaoxiao Xu Kai Xu Tingting Ren Xiangsheng Xiong Weibing Zhao Weibing Zhao |
| author_sort | Jingjing Mao |
| collection | DOAJ |
| description | BackgroundThe 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.MethodsNinety 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 min. The initial PIEB interval time was set at 40 min 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 min. 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.ResultsThe optimal PIEB interval times for ropivacaine concentrations of 0.075%, 0.1%, and 0.125% were determined to be 40.9 (95% CI, 35.3–45.8), 45.3 (95% CI, 39.3–51.5), and 52.9 (95% CI, 46.8–59.3) minutes respectively, while comparable maternal and neonatal outcomes were observed across all groups.ConclusionWhen 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 min respectively. |
| format | Article |
| id | doaj-art-7a209d59a89145e2b559f989cef0cfbd |
| institution | Kabale University |
| issn | 1663-9812 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Pharmacology |
| spelling | doaj-art-7a209d59a89145e2b559f989cef0cfbd2025-01-07T06:42:16ZengFrontiers Media S.A.Frontiers in Pharmacology1663-98122025-01-011510.3389/fphar.2024.15085141508514A 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 analgesiaJingjing Mao0Yi Chen1Linsen Sun2Xiaoxiao Xu3Kai Xu4Tingting Ren5Xiangsheng Xiong6Weibing Zhao7Weibing Zhao8Department of Anesthesiology, Huai’an Hospital Affiliated to Yangzhou University (The Fifth People’s Hospital of Huai’an), Huaian, ChinaDepartment of Anesthesiology and Perioperative Medicine, General Hospital of Ningxia Medical University, Yinchuan, ChinaDepartment of Anesthesiology, Huai’an Hospital Affiliated to Yangzhou University (The Fifth People’s Hospital of Huai’an), Huaian, ChinaDepartment of Anesthesiology, Huai’an Hospital Affiliated to Yangzhou University (The Fifth People’s Hospital of Huai’an), Huaian, ChinaDepartment of Anesthesiology, Huai’an Hospital Affiliated to Yangzhou University (The Fifth People’s Hospital of Huai’an), Huaian, ChinaDepartment of Anesthesiology, Huai’an Hospital Affiliated to Yangzhou University (The Fifth People’s Hospital of Huai’an), Huaian, ChinaDepartment of Anesthesiology, Huai’an Hospital Affiliated to Yangzhou University (The Fifth People’s Hospital of Huai’an), Huaian, ChinaDepartment of Anesthesiology, Huai’an Hospital Affiliated to Yangzhou University (The Fifth People’s Hospital of Huai’an), Huaian, ChinaYangzhou Institute of the Heart and Great Vessels (YIHGV), Yangzhou University, Yangzhou, ChinaBackgroundThe 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.MethodsNinety 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 min. The initial PIEB interval time was set at 40 min 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 min. 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.ResultsThe optimal PIEB interval times for ropivacaine concentrations of 0.075%, 0.1%, and 0.125% were determined to be 40.9 (95% CI, 35.3–45.8), 45.3 (95% CI, 39.3–51.5), and 52.9 (95% CI, 46.8–59.3) minutes respectively, while comparable maternal and neonatal outcomes were observed across all groups.ConclusionWhen 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 min respectively.https://www.frontiersin.org/articles/10.3389/fphar.2024.1508514/fullinterval timeprogrammed intermittent epidural bolusesdifferent concentrationsropivacainedural puncture epidural |
| spellingShingle | Jingjing Mao Yi Chen Linsen Sun Xiaoxiao Xu Kai Xu Tingting Ren Xiangsheng Xiong Weibing Zhao Weibing Zhao 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 Frontiers in Pharmacology interval time programmed intermittent epidural boluses different concentrations ropivacaine dural puncture epidural |
| title | 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 |
| title_full | 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 |
| title_fullStr | 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 |
| title_full_unstemmed | 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 |
| title_short | 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 |
| title_sort | 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 |
| topic | interval time programmed intermittent epidural boluses different concentrations ropivacaine dural puncture epidural |
| url | https://www.frontiersin.org/articles/10.3389/fphar.2024.1508514/full |
| work_keys_str_mv | AT jingjingmao arandomizedsequentialallocationstudyontheoptimumprogrammedintermittentepiduralbolusesintervaltimewithdifferentconcentrationsofropivacainecombinedwiththeduralpunctureepiduraltechniqueforlaboranalgesia AT yichen arandomizedsequentialallocationstudyontheoptimumprogrammedintermittentepiduralbolusesintervaltimewithdifferentconcentrationsofropivacainecombinedwiththeduralpunctureepiduraltechniqueforlaboranalgesia AT linsensun arandomizedsequentialallocationstudyontheoptimumprogrammedintermittentepiduralbolusesintervaltimewithdifferentconcentrationsofropivacainecombinedwiththeduralpunctureepiduraltechniqueforlaboranalgesia AT xiaoxiaoxu arandomizedsequentialallocationstudyontheoptimumprogrammedintermittentepiduralbolusesintervaltimewithdifferentconcentrationsofropivacainecombinedwiththeduralpunctureepiduraltechniqueforlaboranalgesia AT kaixu arandomizedsequentialallocationstudyontheoptimumprogrammedintermittentepiduralbolusesintervaltimewithdifferentconcentrationsofropivacainecombinedwiththeduralpunctureepiduraltechniqueforlaboranalgesia AT tingtingren arandomizedsequentialallocationstudyontheoptimumprogrammedintermittentepiduralbolusesintervaltimewithdifferentconcentrationsofropivacainecombinedwiththeduralpunctureepiduraltechniqueforlaboranalgesia AT xiangshengxiong arandomizedsequentialallocationstudyontheoptimumprogrammedintermittentepiduralbolusesintervaltimewithdifferentconcentrationsofropivacainecombinedwiththeduralpunctureepiduraltechniqueforlaboranalgesia AT weibingzhao arandomizedsequentialallocationstudyontheoptimumprogrammedintermittentepiduralbolusesintervaltimewithdifferentconcentrationsofropivacainecombinedwiththeduralpunctureepiduraltechniqueforlaboranalgesia AT weibingzhao arandomizedsequentialallocationstudyontheoptimumprogrammedintermittentepiduralbolusesintervaltimewithdifferentconcentrationsofropivacainecombinedwiththeduralpunctureepiduraltechniqueforlaboranalgesia AT jingjingmao randomizedsequentialallocationstudyontheoptimumprogrammedintermittentepiduralbolusesintervaltimewithdifferentconcentrationsofropivacainecombinedwiththeduralpunctureepiduraltechniqueforlaboranalgesia AT yichen randomizedsequentialallocationstudyontheoptimumprogrammedintermittentepiduralbolusesintervaltimewithdifferentconcentrationsofropivacainecombinedwiththeduralpunctureepiduraltechniqueforlaboranalgesia AT linsensun randomizedsequentialallocationstudyontheoptimumprogrammedintermittentepiduralbolusesintervaltimewithdifferentconcentrationsofropivacainecombinedwiththeduralpunctureepiduraltechniqueforlaboranalgesia AT xiaoxiaoxu randomizedsequentialallocationstudyontheoptimumprogrammedintermittentepiduralbolusesintervaltimewithdifferentconcentrationsofropivacainecombinedwiththeduralpunctureepiduraltechniqueforlaboranalgesia AT kaixu randomizedsequentialallocationstudyontheoptimumprogrammedintermittentepiduralbolusesintervaltimewithdifferentconcentrationsofropivacainecombinedwiththeduralpunctureepiduraltechniqueforlaboranalgesia AT tingtingren randomizedsequentialallocationstudyontheoptimumprogrammedintermittentepiduralbolusesintervaltimewithdifferentconcentrationsofropivacainecombinedwiththeduralpunctureepiduraltechniqueforlaboranalgesia AT xiangshengxiong randomizedsequentialallocationstudyontheoptimumprogrammedintermittentepiduralbolusesintervaltimewithdifferentconcentrationsofropivacainecombinedwiththeduralpunctureepiduraltechniqueforlaboranalgesia AT weibingzhao randomizedsequentialallocationstudyontheoptimumprogrammedintermittentepiduralbolusesintervaltimewithdifferentconcentrationsofropivacainecombinedwiththeduralpunctureepiduraltechniqueforlaboranalgesia AT weibingzhao randomizedsequentialallocationstudyontheoptimumprogrammedintermittentepiduralbolusesintervaltimewithdifferentconcentrationsofropivacainecombinedwiththeduralpunctureepiduraltechniqueforlaboranalgesia |