Programmed Intermittent Epidural Bolus with Ropivacaine Aims for Safer, More Effective Labor Analgesia Than Continuous Infusion

Labor analgesia rates remain critically low in China (less than 5%) compared to Western countries (up to 60%), often due to patient concerns about inadequate pain relief and distressing motor block from traditional methods. Current standard-of-care, Continuous Epidural Infusion (CEI) with patient-controlled epidural analgesia (PCEA), can lead to higher local anesthetic consumption and potential neurotoxicity. Programmed Intermittent Epidural Bolus (PIEB) is an emerging technique theorized to offer improved safety and efficacy by reducing total anesthetic dose and minimizing motor impairment, addressing key barriers to wider adoption of labor analgesia.

This clinical trial is designed to compare Programmed Intermittent Epidural Bolus (PIEB) using Ropivacaine against Continuous Epidural Infusion (CEI) for labor analgesia in Chinese parturients. The study aims to determine if PIEB offers a safer and more effective regimen. Participants will be randomized to receive either PIEB or CEI, with the primary endpoints focusing on analgesia efficacy, safety profiles, and patient satisfaction. The protocol seeks to address concerns regarding motor block and overall comfort, which are significant factors contributing to low labor analgesia adoption in the region.