Commonly used epidural opioid/local anesthetic solutions for postoperative analgesia

Epidural solution	PCEA				PIEB*		Continuous infusion without PCEA (mL/hour)
Epidural solution	Basal infusion rate (mL/hour)	Bolus volume (mL)	Lockout interval (minutes)	Hourly maximum (mL)	Bolus volume (mL)	Bolus interval (minutes)	Continuous infusion without PCEA (mL/hour)
0.0625% bupivacaine with 2 to 5 mcg/mL fentanyl or 5 to 20 mcg/ml hydromorphone	6 to 12	3 to 4	15 to 20	18 to 22	6 to 10	30 to 75	8 to 14
0.1% bupivacaine with 2 to 5 mcg/mL fentanyl or 5 to 20 mcg/ml hydromorphone	3 to 8^¶	2 to 4^¶	20 to 30	12 to 18	4 to 8	30 to 75	8 to 10
0.1% ropivacaine with 2 to 5 mcg/mL fentanyl	5 to 10^¶	2 to 4^¶	15 to 20	15 to 22	4 to 8	30 to 75	8 to 14

This table shows commonly used solutions and ranges for pump settings for postoperative analgesia. Doses on the low end of the above ranges should be used for thoracic epidural analgesia, especially high-thoracic epidural analgesia, and in older patients. Patients with epidural catheters in place should be monitored for adequacy of analgesia, level of activity tolerated, and side effects or complications of epidural analgesia, and doses adjusted accordingly. For further information refer to UpToDate content on continuous epidural analgesia for postoperative pain.

PCEA: patient-controlled epidural analgesia; PIEB: programmed intermittent epidural bolus.
* Experience with PIEB is primarily with lumbar epidural, and it is best studied for labor analgesia. It is not well studied for thoracic epidural.
¶ If a higher basal infusion rate is used (eg, to improve inadequate analgesia), start with a lower PCEA bolus volume before adjusting further.

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Commonly used epidural opioid/local anesthetic solutions for postoperative analgesia