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Ropivacaine 0.1% with fentanyl 2 μg mL−1 by epidural infusion for labour analgesia

Published online by Cambridge University Press:  28 January 2005

M. C. Atienzar ,
J. M. Palanca ,
R. Borras ,
I. Esteve ,
M. Fernandez  and
A. Miranda
M. C. Atienzar
Affiliation:
Institut Universitari Dexeus, Department of Anaesthesiology, Barcelona, Spain
J. M. Palanca
Affiliation:
Valencia University School of Medicine, Department of Surgery, Valencia, Spain
R. Borras
Affiliation:
Institut Universitari Dexeus, Department of Anaesthesiology, Barcelona, Spain
I. Esteve
Affiliation:
Institut Universitari Dexeus, Department of Anaesthesiology, Barcelona, Spain
M. Fernandez
Affiliation:
Institut Universitari Dexeus, Department of Anaesthesiology, Barcelona, Spain
A. Miranda
Affiliation:
Institut Universitari Dexeus, Department of Anaesthesiology, Barcelona, Spain
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Extract

Summary

Background and objective: To evaluate the efficacy of 0.1% ropivacaine with fentanyl 2 μg mL−1 via epidural for analgesia in labour.

Methods: In a randomized study, 80 nulliparous parturients in labour had epidural analgesia initiated with 0.2% ropivacaine and fentanyl and were then randomized to receive either 0.1% ropivacaine with fentanyl 2 μg mL−1 at 10 mL h−1 (Group R1, n = 38) or 0.2% ropivacaine with fentanyl 2 μg mL−1 at 8 ml h−1 (Group R2, n = 39) as epidural infusions. Supplementary analgesia was provided on request with ropivacaine 0.2% 5 mL as an epidural bolus.

Results: There were no significant differences between the visual analogue pain scores either with respect to motor block or sensory block. The amount of local anaesthetic used was lower in the 0.1% ropivacaine group than in the 0.2% ropivacaine group (P = 0.001). Side-effects, patient satisfaction, labour outcome and neonatal outcomes were similar in both groups.

Conclusions: An epidural infusion of 0.1% ropivacaine with fentanyl 2 μg mL−1 at 10 mL h−1 provided adequate analgesia in the first stage of labour. The level of analgesia was similar to that obtained using 0.2% ropivacaine with fentanyl 2 μg mL−1 and with no differences with regard to motor or sensory block.

Keywords

ANAESTHETICS, LOCAL, ropivacaineANALGESICS, OPIOID, fentanylANAESTHESIA EPIDURAL
Type
Original Article
Information
European Journal of Anaesthesiology , Volume 21 , Issue 10 , October 2004 , pp. 770 - 775
Copyright
© 2004 European Society of Anaesthesiology

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References

Polley LS, Columb MO, Naughton NN, Wagner DS, van de Ven CJ. Relative analgesic potencies of ropivacaine and bupivacaine for epidural analgesia in labor: implications for therapeutic indexes. Anesthesiology 1999; 90: 944–950.Google Scholar
Capogna G, Celleno D, Fusco P, Lyons G, Columb M. Relative potencies of bupivacaine and ropivacaine for analgesia in labour. Br J Anaesth 1999; 82: 371–373.Google Scholar
Fischer C, Blainé P, Jaouën E, Vayssiére C, Kaloul I, Coltat JC. Ropivacaine 0.1% plus sufentanil 0.5 μg/ml versus bupivacaina 0.1% plus sufentanil 0.5 μg/ml using patient controlled epidural analgesia for labor: a double-blind comparison. Anesthesiology 2000; 92: 1588–1593.Google Scholar
Fernandez-Guisasola J, Serrano ML, Cobo B, et al. A comparison of 0.0625% bupivacaine with fentanyl and 0.1% ropivacaine fentanyl for continuous epidural labor analgesia. Anesth Analg 2001; 92: 1261–1265.Google Scholar
Finegold H, Mandell G, Ramanathan S. Comparison of ropivacaine 0.1%-fentanyl and bupivacaine 0.125%-fentanyl infusions for epidural labour analgesia. Can J Anaesth 2000; 47: 740–745.Google Scholar
Smedvig JP, Soreide E, Gjessing L. Ropivacaine 1 mg/ml plus fentanyl 2 μg/ml for epidural analgesia during labor. Is mode of administration important? Acta Anaesthesiolo Scand 2001; 45: 595–599.Google Scholar
Palm S, Gertzen W, Ledowski T, Gleim M, Wulf H. Minimum local analgesic dose of plain ropivacaine combined with sufentanil during epidural analgesia for labour. Anaesthesia 2001; 56: 526–529.Google Scholar
Rodríguez JM, Sánchez-Conde P, Nicolás J, et al. Estudio comparativo entre ropivacaína y bupivacaína en la analgesia epidural del parto. Rev Esp Anestesiol Reanim 2001; 48: 199–203.Google Scholar
Bee L, Ngan Kee WD, Lau WN, Wong AS. Epidural infusion for labor analgesia: a comparison of 0.2% ropivacaine, 0.1% ropivacaine and 0.1% ropivacaine with fentanyl. Reg Anesth Pain Med 2002; 27: 31–36.Google Scholar
Owen M, D'Angelo R, Gerancher JC, et al. 0.125% ropivacaine is similar to 0.125% bupivacaine for labour analgesia utilizing patient-controlled epidural infusion. Anesth Analg 1998; 86: 527–531.Google Scholar
D'Angelo R, Gerancher JC, Eisenach JC, Raphael BL. Epidural fentanyl produces labor analgesia by a spinal mechanism. Anesthesiology 1998; 88: 1519–1523.Google Scholar
Lyzac SZ, Eisenach JC, Dobson CE. Patient-controlled epidural analgesia during labor: a comparison of three solutions with a continuous infusion control. Anesthesiology 1990; 72: 44–49.Google Scholar
Lyons G, Columb M, Hawthorne L, Dresner M. Extradural pain relief in labour: bupivacaine sparing by extradural fentanyl is dose dependent. Br J Anaesth 1997; 78: 493–497.Google Scholar
Melzac R, Taenzer P, Feldman P, Kinch RA. Labour is still painful after prepared childbirth training. Can Med Assoc J 1981; 125: 357–363.Google Scholar
Sheiner E, Sheiner EK, Shoham-Vardi I. The relationship between parity and labour pain. Int J Gynaecol Obstet 1998; 63: 287–288.Google Scholar
Miranda A, Fernández M. Dolor de parto. In: Miranda A, ed. Tratado de Anestesiología y Reanimación en Obstetricia: Principios Fundamentales y Bases de Aplicación Práctica. Barcelona, Spain: Masson, 1997: 109–132.
Brown ST, Campbell D, Kurt A. Characteristics of labor pain at two stages of cervical dilatation. Pain 1989; 38: 289–295.Google Scholar
Corli O, Grossi E, Roma G, Battagliarin G. Correlation between subjective labour pain and uterine contractions. A clinical study. Pain 1986; 26: 53–60.Google Scholar
Bee L, Ngan Kee WD, Wong EL, Liu JY. Dose–response study of epidural ropivacaine for labor analgesia. Anesthesiology 2001; 94: 767–772.Google Scholar
Beilin Y, Galea M, Zahn J, Bodian CA. Epidural ropivacaine for the initiation of labor epidural analgesia: a dose finding study. Anesth Analg 1999; 88: 1340–1345.Google Scholar
Owen MD, Thomas JA, Smith T, Harris L, D'Angelo R. Ropivacaine 0.075% and bupivacaine 0.075% with fentanyl 2 μg/ml are equivalent for labor epidural analgesia. Anesth Analg 2002; 94: 179–183.Google Scholar
Pirbudak L, Tuncer S, Kocoglu H, et al. Fentanyl added to bupivacaine 0.05% or ropivacaine 0.05% in patient-controlled epidural analgesia in labour. Eur J Anaesthesiol 2002; 19: 217–225.Google Scholar
Capogna G, Celleno D, Lyons G, et al. Minimum local analgesic concentration of extradural bupivacaine increases with progression of labour. Br J Anaesth 1998; 80: 11–13.Google Scholar
Brownridge P. Epidural analgesia in the first stage of labour. Curr Anaesth Crit Care 1991; 2: 92–100.Google Scholar
Curatolo M, Scaramozzino P, Venuti FS, Orlando A, Zbinden AM. Factors associated with hypotension and bradycardia after epidural blockade. Anesth Analg 1996; 83: 1033–1040.Google Scholar
Johnson C, Ransil BJ, Oriol N. Comparison of onset time between 0.5% bupivacaine and 3% 2-choro-coprocaine with and without 75 μg fentanyl. Reg Anesth 1991; 16: 228–231.Google Scholar
Kaneko M, Saito Y, Kirihara Y, Collins JG, Kosaka Y. Synergistic antinociceptive interaction after epidural coadministration of morphine and lidocaine in rats. Anesthesiology 1994; 80: 137–150.Google Scholar
Scott DA, Blake D, Buckland M, et al. A comparison of epidural ropivacaine infusion alone and in combination with 1, 2 and 4 μg/ml fentanyl for seventy-two hours of postoperative analgesia after major abdominal surgery. Anesth Analg 1999; 88: 857–864.Google Scholar