The goal of this randomized controlled trial is to examine the impact of programmed intermittent bolus epidural analgesia technique on the incidence of breakthrough pain during labor in multiparous women compared to continuous epidural infusion.
multiparous women will randomly be divided during labor into two groups; study group will receive mix of Bupivacaine and fentanyl once (bolus) every 60 minutes; the control group will receive continuously the same dose during an hour, until delivery.
multiparous women
Term pregnancy
Singleton
Vertex presentation
Estimated fetal weight greater than 4.0 kg
Intra uterine fetal death
Drug sensitivity