Programmed Intermittent Epidural Boluses (PIEB): A Superior Technique for Maitenance of Labor Analgesia

egional analgesia is currently the most effective form of pain relief for women in labor and may include an epidural, a spinal or a combination of the two techniques. The evolution of maintenance of epidural analgesia has progressed from manually delivered intermittent boluses to continuous epidural infusion (CEI), to the addition of patient-controlled epidural analgesia (PCEA) boluses for breakthrough pain and now programmed intermittent epidural bolus (PIEB). PIEB has evolved as a superior method for delivering labor analgesia due to reduced hourly local anesthetic consumption, less need for clinician intervention, and improved maternal pain and satisfaction scores.