Abstract

Background: Intermittent epidural bolus (IEB) is an effective technique for labor analgesia and has been increasingly adopted in recent years. By improving the distribution of local anesthetics within the epidural space, IEB enhances sensory block, minimizes motor blockade, and reduces the need for rescue boluses compared with continuous epidural infusion (CEI). This study evaluates the efficacy and safety of intermittent epidural bolus compared with continuous epidural infusion of ropivacaine for labor analgesia.

Methods: A prospective, randomized comparativestudy was conducted on 90 parturients receiving epidural labor analgesia, who were assigned to either continuous epidural infusion group (CEI) n=45 and the intermittent epidural bolus group (IEB) n=45 of ropivacaine 0,1% combined with fentanyl 2 µg/mL for vaginal delivery at Tu Du Hospital from May2023 to May 2024.

Results: No statistically significant differences were observed in baseline maternal and obstetric characteristics between the two study groups. In the IEB group, VAS pain scores at all time points were lower than those in the CEI group (p < 0,05). In the CEI group, the proportion of patients with VAS scores > 3 was 55,6%, which was significantly higher than the 6,7% observed in the IEB group (p < 0,001). The number of rescue bolus administrations and the frequency of healthcare staff interventions were also higher in the CEI group compared with the IEB group (p < 0,01). The mean hourly consumption of local anesthetic in the CEI group was 13,7 mg, which was higher than 10,8 mg in the IEB group (p < 0,001). No patients in the IEB group experienced motor blockade, whereas six patients in the CEI group did (p < 0,05). There were no statistically significant differences between the two groups in maternal satisfaction, adverse effects, or neonatal Apgar scores.

Conclusion: IEB administration for labor analgesia provides superior analgesic efficacy, reduces motor blockade, and decreases total local anesthetic consumption compared with continuous epidural infusion.