The introduction of epidural analgesia to delivery rooms meant a fundamental advance at a moment of a woman’s life that can be both traumatic and happy at the same time. Today the epidural analgesia is used in all hospital delivery rooms, at least in more developed countries.

This analgesia not only means reducing or removing the feeling of pain during birth, but it also helps to significantly reduce the mother’s anxiety level, improves maternal oxygenation as it reduces hyperventilation and allows the use of technical instruments and to give birth by caesarean section without having to necessarily use general anaesthesia.

Evolution of the epidural analgesia technique

The epidural analgesia technique has also been evolved and perfected over time. From the manual administration of boluses using a needle to continuous infusion using a catheter and infusion pump. It was precisely because of the evolution of infusion pump technology which enabled the development of new ways of administration such as epidural analgesia by Programmed Intermittent Epidural Boluses, or PIEB, and Patient-Controlled Epidural Analgesia, or PCEA.

Both PIEB and PCEA would not have been possible without the existence of smart infusion pumps such as the ones in the arcomed Chroma series and the different function modes they offer (among which both techniques are included).

The arcomed Chroma pumps working in PIEB mode also enable the doctors to program a background infusion and programmed intermittent boluses. The patient can also request additional boluses (PCEA). In this case, a lockout time is set between the demanded bolus and the next programmed bolus .This avoids risk of overdosing.

PIEB vs. continuous infusion

Epidural analgesia using the infusion of programmed intermittent boluses has shown to be not only effective in pain control, but also has certain benefits over epidural analgesia through continuous infusion.

  • Less medication consumption. Especially when it is combined with PCEA.
  • Reduction in motor block incidences after the epidural analgesia and other side effects, as well as shorter recovery times.
  • Some studies show fewer incidences of instrumental births with the use of PIEB (Capogna, Camorcia et. al).
  • Greater subjective satisfaction from the mother as they are able to control their own pain to a certain extent. This has a significant impact on the perception of quality of care received during the birth.