Continuous patient‐controlled epidural infusion of levobupivacaine plus sufentanil in labouring primiparous women: effects of concentration*

Abstract

SummaryThe effects of two different concentrations of epidural levobupivacaine were compared when used to provide analgesia for labour. Primiparous women in spontaneous uncomplicated labour were enrolled in a prospective, randomised and partially double-blinded study. The study solutions were either 0.568 mg.ml )1 levobupivacaine (low concentration group) or 1.136 mg.ml )1 levobupivacaine (high concentration group), with sufentanil 0.45 lg.ml )1 added to both solutions. Epidural analgesia was initiated with 20 ml of the study solution, followed by a standardised algorithm of top-up bolus injections. Epidural analgesia was then continued by self-administered boluses of 5-ml plus a continuous infusion of 5 ml.h)1

Addition of clonidine to a continuous patient‐controlled epidural infusion of low‐concentration levobupivacaine plus sufentanil in primiparous women during labour

“…These include lowering the concentration of local anaesthetics and/or adding opioids to the anaesthetic solution, and developing less toxic drugs than bupivacaine [1]. We recently studied the effects of two formulations of levobupivacaine (0.0625% and 0.125%) for analgesia during labour in primiparous women, both with sufentanil 0.45 μg.ml −1 [2]. The solution was patient‐administered after a first injection of 15–20 ml for induction.…”

Local Anaesthetic Epidural Solution for Labour: About Concentrations and Additives

“…We planned a randomised, controlled and double-blinded trial (see ClinicalTrials.gov NCT00929682, and (Tixier et al, 2010)). …”

“…The volumes used and the maintenance regimens (PCEA) were similar to those used in the previous study (Tixier et al, 2010). The inclusion and non-inclusion criteria were also the same, except the required cervical dilatation set to ≤ 5 cm.…”

“…The sample size estimation was based on the values for the primary outcome that were noted in the previous study (Tixier et al, 2010). As clonidine was not labelled for epidural administration during labour in France, we planned interim analyses, to be able to discontinue the trial in case of safety problems.…”

Levobupivacaine for Regional Anesthesia and Pain Management

“…91 The effect of clonidine (at 2 mcg/mL) on 0.0625% levobupivacaine combined with sufentanil 0.25 mcg/mL using a patient-controlled epidural analgesia technique was an improvement in analgesia, but with a reduction in blood pressure, albeit still in the normal range. 92 The studies comparing levobupivacaine and ropivacaine for labour analgesia have been confusing.…”