A multicentre trial comparing different concentrations of ropivacaine plus sufentanil with bupivacaine plus sufentanil for patient-controlled epidural analgesia in labour
| Autor: | W, Gogarten, M, Van de Velde, F, Soetens, H, Van Aken, G, Brodner, H F, Gramke, M, Soetens, M A E, Marcus |
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| Rok vydání: | 2004 |
| Předmět: |
Adult
Dose-Response Relationship Drug Cesarean Section Sufentanil Analgesia Patient-Controlled Nerve Block Heart Rate Fetal Amides Bupivacaine Analgesia Epidural Double-Blind Method Heart Rate Pregnancy Analgesia Obstetrical Humans Female Ropivacaine Anesthetics Local Anesthetics Intravenous Abdominal Muscles Pain Measurement |
| Zdroj: | European journal of anaesthesiology. 21(1) |
| ISSN: | 0265-0215 |
| Popis: | To determine the optimal concentration of ropivacaine for bolus-only patient-controlled epidural labour analgesia, three different doses of ropivacaine were evaluated in comparison with bupivacaine in a double-blinded multicentre study.Four hundred-and-fifty labouring parturients at term in three different academic institutions were randomized to four groups receiving bupivacaine 0.125% with sufentanil 0.75 microg mL(-1), ropivacaine 0.125% or 0.175% with sufentanil 0.75 microg mL(-1), or ropivacaine 0.2%. After an initial bolus of 10 mL of the study solution, and once visual analogue scores (VAS) were below 30 mm, patient-controlled epidural analgesia was initiated with a bolus of 4 mL, a lockout interval of 15 min and without a background infusion. Variables studied were the quality of analgesia, incidence of side-effects, the degree of motor blockade, and the mode of delivery.Bupivacaine 0.125% and ropivacaine 0.125% with sufentanil proved equally effective in providing labour analgesia without a difference in local anaesthetic consumption (48.6 +/- 23 mg bupivacaine vs. 52.1 +/- 38 mg ropivacaine), motor blockade or mode of delivery. Ropivacaine 0.175% plus sufentanil enhanced the quality of analgesia of the initial loading dose, whereas ropivacaine 0.2% without sufentanil increased the consumption of local anaesthetics (80.2 +/- 34 mg; P0.05) and the degree of motor blockade.Despite recent studies indicating that bupivacaine and ropivacaine may not be equipotent, both local anaesthetics provided equi-effective analgesia at equal doses without a difference in side-effects. |
| Databáze: | OpenAIRE |
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