Programmed intermittent bolus versus continuous infusion technique in peripheral nerve blockade: an evidence-based review
Peripheral nerve catheters with continuous infusion of local anesthesia are a mainstay of postoperative analgesia. Programmed intermittent bolus (PIB) as an alternative to continuous infusion allows a set volume of solution to be given as a bolus at a set interval of time. PIB has been purported to provide improved spread of local anesthetic within anatomic compartments. Although an optimal dose and interval has yet to be elucidated, benefits of PIB have been shown in a number of studies involving labor epidural management. However, the benefit of PIB in peripheral nerve blockade (PNB) is unclear, and studies have largely demonstrated conflicting results. We aimed to conduct a review to synthesize and summarize the existing knowledge comparing PIB with continuous infusion in PNB and provide recommendations based on this evidence.