Ropivacaine and levobupivacaine have been introduced into obstetric analgesic practice with the proposed advantages of causing less motor block and toxicity compared with bupivacaine. However, it is still controversia...Ropivacaine and levobupivacaine have been introduced into obstetric analgesic practice with the proposed advantages of causing less motor block and toxicity compared with bupivacaine. However, it is still controversial whether both anesthetics are associated with any clinical benefit relative to bupivacaine for labor analgesia. This study aimed to compare the analgesic efficacy, motor block and side effects of bupivacaine, ropivacaine and levobupivacaine at lower concentrations for patient-controlled epidural labor analgesia. Methods Four hundred and fifty nulliparous parturients were enrolled in this randomized clinical trial. A concentration of 0.05%, 0.075%, 0.1%, 0.125% or 0.15% of either bupivacaine （Group B）, ropivacaine （Group R） or levobupivacaine （Group L） with sufentanil 0.5 ug/ml was epidurally administered by patient-controlled analgesia mode. Effective analgesia was defined as a visual analogue scale score was 〈30 mm. The relative median potency for each local anesthetic was calculated using a probit regression model. Parturients demographics, sensory and motor blockade, obstetric data, maternal side effects, hourly volumes of local anesthetic used, and others were also noted. Results There were no significant differences among groups in the numbers of effective analgesia, pain scores, hourly local anesthetic amount used, sensory and motor blockade, labor duration and mode of delivery, side effects and maternal satisfaction （P 〉0.05）. The relative median potency was bupivacaine/ropivacaine： 0.828 （0.602-1.091）, bupivacaine/levobupivacaine： 0.845 （0.617-1.12）, ropivacaine/levobupivacaine： 1.021 （0.774-1.354）, respectively. However, a significantly less number of effective analgesia and higher hourly local anesthetic use were observed in the concentration of 0.05% than those of 〉0.1% within each group （P 〈0.05）. Conclusions Using patient-controlled epidural analgesia, lower concentrations of bupivacaine, ropivacaine and levobupivacaine with s＇ufentanil pr展开更多
目的比较左旋布比卡因、罗比卡因和布比卡因用于硬膜外麻醉剖宫产术的阻滞效果、母婴安全和药物不良反应。方法采用随机双盲法,将48例择期剖宫产手术的足月单胎产妇分为三组:0.5%左旋布比卡因组(L组)17例、0.5%罗比卡因组(R组)15例和0.5...目的比较左旋布比卡因、罗比卡因和布比卡因用于硬膜外麻醉剖宫产术的阻滞效果、母婴安全和药物不良反应。方法采用随机双盲法,将48例择期剖宫产手术的足月单胎产妇分为三组:0.5%左旋布比卡因组(L组)17例、0.5%罗比卡因组(R组)15例和0.5%布比卡因组(B组)16例。记录硬膜外腔给药后产妇的感觉阻滞和运动阻滞的起效和持续时间、肌松满意程度、麻醉质量评价、恶心和呕吐等不良反应及术中心率、血压、脉搏血氧饱和度和新生儿1 min和5 min Apgar评分。结果产妇的一般情况、新生儿的Apgar评分组间无显著性差异;三组术中低血压及其他不良事件(恶心和呕吐)的发生率无显著性差异;各组的麻醉质量(术中的疼痛评分和肌松满意度)基本一致;感觉阻滞起效和维持时间组间无显著性差异,运动阻滞改良Bromage评分为1分的起效时间和持续时间组间有显著性差异。结论常用量0.5%左旋布比卡因、罗比卡因和布比卡因用于剖宫产手术的硬膜外麻醉时具有相似的麻醉效能和安全性。展开更多
文摘Ropivacaine and levobupivacaine have been introduced into obstetric analgesic practice with the proposed advantages of causing less motor block and toxicity compared with bupivacaine. However, it is still controversial whether both anesthetics are associated with any clinical benefit relative to bupivacaine for labor analgesia. This study aimed to compare the analgesic efficacy, motor block and side effects of bupivacaine, ropivacaine and levobupivacaine at lower concentrations for patient-controlled epidural labor analgesia. Methods Four hundred and fifty nulliparous parturients were enrolled in this randomized clinical trial. A concentration of 0.05%, 0.075%, 0.1%, 0.125% or 0.15% of either bupivacaine （Group B）, ropivacaine （Group R） or levobupivacaine （Group L） with sufentanil 0.5 ug/ml was epidurally administered by patient-controlled analgesia mode. Effective analgesia was defined as a visual analogue scale score was 〈30 mm. The relative median potency for each local anesthetic was calculated using a probit regression model. Parturients demographics, sensory and motor blockade, obstetric data, maternal side effects, hourly volumes of local anesthetic used, and others were also noted. Results There were no significant differences among groups in the numbers of effective analgesia, pain scores, hourly local anesthetic amount used, sensory and motor blockade, labor duration and mode of delivery, side effects and maternal satisfaction （P 〉0.05）. The relative median potency was bupivacaine/ropivacaine： 0.828 （0.602-1.091）, bupivacaine/levobupivacaine： 0.845 （0.617-1.12）, ropivacaine/levobupivacaine： 1.021 （0.774-1.354）, respectively. However, a significantly less number of effective analgesia and higher hourly local anesthetic use were observed in the concentration of 0.05% than those of 〉0.1% within each group （P 〈0.05）. Conclusions Using patient-controlled epidural analgesia, lower concentrations of bupivacaine, ropivacaine and levobupivacaine with s＇ufentanil pr
文摘目的比较左旋布比卡因、罗比卡因和布比卡因用于硬膜外麻醉剖宫产术的阻滞效果、母婴安全和药物不良反应。方法采用随机双盲法,将48例择期剖宫产手术的足月单胎产妇分为三组:0.5%左旋布比卡因组(L组)17例、0.5%罗比卡因组(R组)15例和0.5%布比卡因组(B组)16例。记录硬膜外腔给药后产妇的感觉阻滞和运动阻滞的起效和持续时间、肌松满意程度、麻醉质量评价、恶心和呕吐等不良反应及术中心率、血压、脉搏血氧饱和度和新生儿1 min和5 min Apgar评分。结果产妇的一般情况、新生儿的Apgar评分组间无显著性差异;三组术中低血压及其他不良事件(恶心和呕吐)的发生率无显著性差异;各组的麻醉质量(术中的疼痛评分和肌松满意度)基本一致;感觉阻滞起效和维持时间组间无显著性差异,运动阻滞改良Bromage评分为1分的起效时间和持续时间组间有显著性差异。结论常用量0.5%左旋布比卡因、罗比卡因和布比卡因用于剖宫产手术的硬膜外麻醉时具有相似的麻醉效能和安全性。
