Determination of the Optimal Programmed Intermittent Epidural Bolus Volume of Bupivacaine 0.0625% With Fentanyl 2 μg/mL at a Fixed Interval of 40 Minutes: A Biased Coin Up-and-down Sequential Allocation Trial
Bibliographic record
Abstract
(Anaesthesia. 2018;73:459–465) The use of programmed intermittent epidural bolus (PIEB) to provide labor analgesia has been increasing in popularity as commercially available pumps have become available. A variety of dosing strategies have been evaluated but the optimal settings for PIEB have not yet been established. The majority of studies have included PIEB in conjunction with patient controlled epidural analgesia (PCEA). The current investigators had previously investigated which PIEB dosing strategy would minimize breakthrough pain and the need for PCEA boluses. They determined the optimal regimen was 10 mL of bupivacaine 0.0625% with fentanyl 2 µg/ml administered every 40 minutes. However, 34% of women exhibited a sensory block to ice above T6, which might indicate an unnecessarily high spread of local anesthetic. Therefore, they conducted this prospective, double-blind, dose-finding study to investigate whether it was possible to reduce the PIEB volume without compromising the efficacy of the technique.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.005 | 0.006 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.003 | 0.002 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.002 | 0.002 |
| Insufficient payload (model declined to judge) | 0.004 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".