Efficacy of ropivacaine, bupivacaine, and levobupivacaine for labor epidural analgesia

Sah, Neera; Vallejo, Manuel C.; Phelps, Amy L.; Finegold, Helene; Mandell, Gordon L.; Ramanathan, Sivam

doi:10.1016/j.jclinane.2006.11.003

Cited by 20 publications

(14 citation statements)

References 8 publications

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“…VAS (pain score) was statistically significantly reduced (p < 0.05) from the baseline till the delivery of baby. [7][8][9][10][11][12][13] As compare to the previous studies of various authors who used ropivacaine + fentanyl combination and our findings were almost similar, regarding duration of analgesia in minutes (Mean ± S.D. = 171.6 ± 13.13).…”

Section: Discussionsupporting

confidence: 85%

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Comparative Study of 0.1%Ropivacaine-Fentanyl with 0.1%Bupivacaine-Fentanyl Given Epidurally for Labour Analgesia

Rana¹,

Kothari²,

Shah³

et al. 2019

IJCMR

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Introduction: Addition of fentanyl to bupivacaine or ropivacaine in epidural space will increase duration and quality of analgesia with similar safety profile. Study aimed to compare epidural Inj. Bupivacaine 0.1% + Inj. Fentanyl and Inj. Ropivacaine 0.1% + Inj. Fentanyl for onset, effectiveness and duration of analgesia, to study motor blockade intensity, to study hemodynamic parameters, to study technical and drug related complications in mother and baby and to study acceptability of technique by patient. Material and methods: A prospective interventional study was conducted on 50 adult females with primigravida / multigravida full term pregnancy for epidural analgesia under ASA 1 & 2. Unpaired Student t test was used to interpret the results. Results: Patients got more pain relief and satisfaction with ropivacaine+fentanyl as compare to bupivacaine+fentanyl. Conclusions: Addition of fentanyl to bupivacaine or ropivacaine in epidural space increase duration and quality of analgesia with similar safety profile and reduce the requirement of local anesthetic drugs during labour. It did not hamper ambulation and bearing down of patient and had similar incidence of maternal and fetal outcome, with good patient satisfaction.

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Section: Discussionsupporting

confidence: 85%

“…VAS (pain score) was statistically significant (p< 0.05) from the baseline till the delivery of baby. [7][8][9][10][11][12][13] Duration of analgesia after 1st dose in minutes in group B (Mean ± S.D. = 162 ± 23.8) and in group R (Mean ± S.D.…”

Section: Discussionmentioning

confidence: 99%

Comparative Study of 0.1%Ropivacaine-Fentanyl with 0.1%Bupivacaine-Fentanyl Given Epidurally for Labour Analgesia

Rana¹,

Kothari²,

Shah³

et al. 2019

IJCMR

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“…[4514] This could be attributed to the lower concentration of local anesthetics (0.1%) and fentanyl (24 µg) used in our study. On comparing between these two drugs, the mean onset time of analgesia was higher for levobupivacaine than ropivacaine which we contribute to the pharmacokinetic property of ropivacaine which is less fat-soluble than levobupivacaine.…”

Section: Discussionmentioning

confidence: 97%

Quality of labor epidural analgesia and maternal outcome with levobupivacaine and ropivacaine: A double-blinded randomized trial

et al. 2017

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Background:Quality of labor analgesia plays a vital role in the maternal outcome. Very few literature are available analyzing the quality of epidural labor analgesia.Aim:The aim of this study was to compare the effectiveness of 0.1% levobupivacaine and 0.1% ropivacaine with fentanyl as an adjuvant for epidural labor analgesia in terms of onset, duration, quality of analgesia, and degree of motor blockade.Methodology:Sixty nulliparous parturients, with singleton uncomplicated pregnancy, were recruited by continuous sampling. Parturients were randomized to receive either levobupivacaine 0.1% or ropivacaine 0.1% with 2 μg/ml fentanyl as an intermittent epidural bolus. The epidural analgesia was initiated with 12 ml of study drug solution in the active stage of labor (cervix 3 cm dilated). Demand bolus was given whenever the visual analog scale (VAS) score >3. Onset, duration, and quality of analgesia and degree of motor blockade were analyzed. Maternal outcome was evaluated in terms of mode of delivery, duration of labor, and assisted vaginal delivery.Statistical Analysis:All the data were recorded in Microsoft Office Excel. Statistical analysis was carried out using SPSS version 19.0 (IBM SPSS, USA) software with Regression Modules installed. Descriptive analyses were reported as mean and standard deviation of continuous variables.Results:The mean onset of analgesia was shorter in ropivacaine (21.43 ± 2 min) than in levobupivacaine group (23.57 ± 1.71 min) (P = 0.000). Duration of analgesia was shorter in ropivacaine (60 ± 14 min) than levobupivacaine (68 ± 11 min) (P = 0.027). Levobupivacaine produced a better quality of analgesia in terms of not perceiving pain and uterine contraction during labor analgesia but was associated with 37% incidence of instrumental delivery. Duration of labor and rate of cesarean section were comparable between the groups.Conclusion:Quality of analgesia in labor epidural was superior to levobupivacaine but was associated with higher incidence of instrumental vaginal delivery.

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“…Levobupivacaine, the pure S ())-enantiomer of bupivacaine, has emerged as a safer alternative than its racemic parent [1,2]. It has been claimed to be more potent than bupivacaine [3,4] or ropivacaine [5], and to cause less motor impairment [4,[6][7][8], although there is little evidence to support this [1]. Levobupivacaine is commercially available in France in pre-filled bags at two different concentrations (0.625 and 1.25 mg.ml )1 ).…”

mentioning

confidence: 99%

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

Bonnin²,

Vernis³

et al. 2010

Anaesthesia

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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

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Efficacy of ropivacaine, bupivacaine, and levobupivacaine for labor epidural analgesia

Cited by 20 publications

References 8 publications

Comparative Study of 0.1%Ropivacaine-Fentanyl with 0.1%Bupivacaine-Fentanyl Given Epidurally for Labour Analgesia

Comparative Study of 0.1%Ropivacaine-Fentanyl with 0.1%Bupivacaine-Fentanyl Given Epidurally for Labour Analgesia

Quality of labor epidural analgesia and maternal outcome with levobupivacaine and ropivacaine: A double-blinded randomized trial

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

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