JOURNAL HOME CME HOME THIS MONTH PAST ISSUES ETOC COLLECTIONS
AUTHORS REVIEWERS EDITORIAL BOARD FEEDBACK RSS HELP
A&A International Anesthesia Research Society
QUICK SEARCH:   [advanced]


     

This Article
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow En Espanol
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Services
Right arrow Email this article to a colleague
Right arrow Similar articles in this journal
Right arrow Similar articles in ISI Web of Science
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Download to citation manager
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via ISI Web of Science (46)
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Campbell, D. C.
Right arrow Articles by Yip, R. W.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Campbell, D. C.
Right arrow Articles by Yip, R. W.
Anesth Analg 2000;90:1384-1389
© 2000 International Anesthesia Research Society

OBSTETRIC ANESTHESIA

Ambulatory Labor Epidural Analgesia: Bupivacaine Versus Ropivacaine

David C. Campbell, MD, MSc, FRCPC, Rhonda M. Zwack, MD, Lesley-Ann L. Crone, MD, FRCPC, and Ray W. Yip, MD, FRCPC

Department of Anesthesiology, Royal University Hospital, University of Saskatchewan, Saskatoon, Saskatchewan, Canada

Address correspondence and reprint requests to David C. Campbell, MD, MSc, FRCPC, Department of Anesthesiology, Royal University Hospital, University of Saskatchewan, 103 Hospital Dr., Saskatoon, Saskatchewan, Canada S7N 0W8. Address e-mail to campbelld{at}sdh.sk.ca

Dilute concentrations of bupivacaine combined with fentanyl have recently been used to initiate labor epidural analgesia in an attempt to balance adequate analgesia and minimal maternal motor blockade. Similar concentrations of ropivacaine have not been evaluated. This prospective, randomized, double-blinded study was designed to compare the efficacy of 20 mL of either 0.08% bupivacaine plus 2 µg/mL fentanyl or 0.08% ropivacaine plus 2 µg/mL fentanyl to initiate ambulatory labor epidural analgesia. Forty nulliparous women in early (<=5 cm) established labor received either 20 mL of 0.08% bupivacaine plus 2 µg/mL fentanyl (BF) or 0.08% ropivacaine plus 2 µg/mL fentanyl (RF) to initiate epidural analgesia. One woman (BF) required supplemental analgesia, and two (one BF and one RF) had visual analog scale scores > 0 but < 20 at 20 min. The time (mean ± SD) to visual analog scale score = 0 was BF (n = 18): 12.0 ± 4.5 min and RF (n = 19): 12.4 ± 4.0 min (P > 0.05). Spontaneous micturition was observed in 65% (13 of 20) BF compared with 100% (20 of 20) RF (P < 0.01), and ambulation was demonstrated in 75% (15 of 20) BF compared with 100% (20 of 20) RF (P < 0.03). The incidence of forceps delivery was 35% (7 of 20) BF compared with 10% (2 of 20) RF (P < 0.04). The results of this study indicate that dilute ropivacaine combined with fentanyl effectively initiates epidural analgesia while concurrently preserving maternal ability to void and ambulate.

Implications: As compared with a similar dilute concentration of bupivacaine, 20 mL of dilute (0.08%) ropivacaine combined with fentanyl (2 µg/mL) effectively initiates epidural analgesia in nulliparous women in early, established labor while preserving their ability to micturate and ambulate. Of importance, it appears that a true ambulatory epidural analgesic for women in labor is now possible.




This article has been cited by other articles:


Home page
 Anesth. Analg.Home page
Y. Beilin, N. R. Guinn, H. H. Bernstein, J. Zahn, S. Hossain, and C. A. Bodian
Local Anesthetics and Mode of Delivery: Bupivacaine Versus Ropivacaine Versus Levobupivacaine
Anesth. Analg., September 1, 2007; 105(3): 756 - 763.
[Abstract] [Full Text] [PDF]

Home page
 Canadian J. AnesthesiaHome page
J. McBain, E. G. Lemire, and D. C. Campbell
Epidural labour analgesia in a parturient with Noonan syndrome: a case report: [Analgesie peridurale chez une parturiente atteinte du syndrome de Noonan : une presentation de cas].
Can J Anesth, March 1, 2006; 53(3): 274 - 278.
[Abstract] [Full Text] [PDF]

Home page
 Canadian J. AnesthesiaHome page
D. C. Campbell, T. Tran, and W. McKay
Conversion of Epidural Labour Analgesia to Epidural Surgical Anesthesia for Intrapartum Caesarean Delivery
Can J Anesth, June 1, 2005; 52(suppl_1): A133 - A133.
[Full Text] [PDF]

Home page
 Canadian J. AnesthesiaHome page
Canadian Anesthesiologists' Society Annual Meeting: Award-Winning Abstracts
Can J Anesth, December 1, 2004; 51(10): A1 - A10.
[Full Text] [PDF]

Home page
 Canadian J. AnesthesiaHome page
D. C. Campbell, T. W. Breen, S. Halpern, H. Muir, and R. Nunn
EFFICACY OF PCEA vs PCEA + CIEA FOR AMBULATORY LABOUR ANALGESIA
Can J Anesth, June 1, 2004; 51(suppl_1): A8 - A8.
[Full Text] [PDF]

Home page
 Canadian J. AnesthesiaHome page
D. C. Campbell, T. W. Breen, S. Halpern, H. Muir, and R. Nunn
RCT COMPARING PCEA vs PCEA + CIEA ON LABOUR OUTCOME
Can J Anesth, June 1, 2004; 51(suppl_1): A9 - A9.
[Full Text] [PDF]

Home page
 Anesth. Analg.Home page
B. B. Lee, W. D. Ngan Kee, F. F. Ng, T. K. Lau, and E. L. Y. Wong
Epidural Infusions of Ropivacaine and Bupivacaine for Labor Analgesia: A Randomized, Double-Blind Study of Obstetric Outcome
Anesth. Analg., April 1, 2004; 98(4): 1145 - 1152.
[Abstract] [Full Text] [PDF]

Home page
 Anesth. Analg.Home page
M. Senard, A. Kaba, M. J. Jacquemin, L. M. Maquoi, M.-P. N. Geortay, P. D. Honore, M. L. Lamy, and J. L. Joris
Epidural Levobupivacaine 0.1% or Ropivacaine 0.1% Combined with Morphine Provides Comparable Analgesia After Abdominal Surgery
Anesth. Analg., February 1, 2004; 98(2): 389 - 394.
[Abstract] [Full Text] [PDF]

Home page
 Anesth. Analg.Home page
S. Frenea, C. Chirossel, R. Rodriguez, J.-P. Baguet, C. Racinet, and J.-F. Payen
The Effects of Prolonged Ambulation on Labor with Epidural Analgesia
Anesth. Analg., January 1, 2004; 98(1): 224 - 229.
[Abstract] [Full Text] [PDF]

Home page
 Anesth. Analg.Home page
J.-M. Bernard, D. Le Roux, and J. Frouin
Ropivacaine and Fentanyl Concentrations in Patient-Controlled Epidural Analgesia During Labor: A Volume-Range Study
Anesth. Analg., December 1, 2003; 97(6): 1800 - 1807.
[Abstract] [Full Text] [PDF]

Home page
 Anesth. Analg.Home page
M. W. Hollmann, K. Kurz, S. Herroeder, D. Struemper, K. Hahnenkamp, N. S. Berkelmans, C. G. den Bakker, and M. E. Durieux
The Effects of S(-)-, R(+)-, and Racemic Bupivacaine on Lysophosphatidate-Induced Priming of Human Neutrophils
Anesth. Analg., October 1, 2003; 97(4): 1053 - 1058.
[Abstract] [Full Text] [PDF]

Home page
 Anesth. Analg.Home page
N. R. Connelly, R. K. Parker, T. Pedersen, T. Manikantan, T. Lucas, S. Serban, M. El-Mansouri, S. DuBois, E. D. Santos, A. Rizvi, et al.
Diluent Volume for Epidural Fentanyl and Its Effect on Analgesia in Early Labor
Anesth. Analg., June 1, 2003; 96(6): 1799 - 1804.
[Abstract] [Full Text] [PDF]

Home page
 Canadian J. AnesthesiaHome page
D. C. Campbell
Labour analgesia: what's new and PCEA too?
Can J Anesth, June 1, 2003; 50(90001): R8 - 8.
[Full Text]

Home page
 Anesth. Analg.Home page
L. S. Polley and M. O. Columb
Ropivacaine and Bupivacaine: Concentrating on Dosing!
Anesth. Analg., May 1, 2003; 96(5): 1251 - 1253.
[Full Text] [PDF]

Home page
 Anesth. Analg.Home page
S. H. Halpern and V. Walsh
Epidural Ropivacaine Versus Bupivacaine for Labor: A Meta-Analysis
Anesth. Analg., May 1, 2003; 96(5): 1473 - 1479.
[Abstract] [Full Text] [PDF]

Home page
 Anesth. Analg.Home page
R. Landau, E. Schiffer, M. Morales, G. Savoldelli, and C. Kern
The Dose-Sparing Effect of Clonidine Added to Ropivacaine for Labor Epidural Analgesia
Anesth. Analg., September 1, 2002; 95(3): 728 - 734.
[Abstract] [Full Text] [PDF]

Home page
 Br J AnaesthHome page
H. J. Clement, L. Caruso, F. Lopez, F. Broisin, M. Blanc-Jouvan, E. Derre-Brunet, A. Thomasson, G. Leboucher, and J. P. Viale
Epidural analgesia with 0.15% ropivacaine plus sufentanil 0.5 {micro}g ml-1versus 0.10% bupivacaine plus sufentanil 0.5 {micro}g ml-1: a double-blind comparison during labour
Br. J. Anaesth., June 1, 2002; 88(6): 809 - 813.
[Abstract] [Full Text] [PDF]

Home page
 Canadian J. AnesthesiaHome page
R. K. Parker, N. R. Connelly, T. Lucas, U. Faheem, A. S. Rizvi, M. El-Mansouri, N. Thakkar, R. Kamasumadram, K. Dixon, S. M. Dunn, et al.
The addition of hydromorphone to epidural fentanyl does not affect analgesia in early labour: [L'addition d'hydromorphone a l'injection epidurale de fentanyl n'affecte pas l'analgesie au debut du travail]
Can J Anesth, June 1, 2002; 49(6): 600 - 604.
[Abstract] [Full Text] [PDF]

Home page
 Canadian J. AnesthesiaHome page
H. P. Ng, K. F. Cheong, A. Lim, J. Lim, and M. E. Puhaindran
Intraoperative single-shot "3-in-1" femoral nerve block with ropivacaine 0.25%, ropivacaine 0.5% or bupivacaine 0.25% provides comparable 48-hr analgesia after unilateral total knee replacement : [Le blocage peroperatoire "3 en 1" du nerf femoral par une dose unique de ropivacaine a 0,25 % ou a 0,5 % ou de bupivacaine a 0,25 % produit une analgesie de 48 h comparable apres la mise en place d'une prothese totale de genou]
Can J Anesth, December 1, 2001; 48(11): 1102 - 1108.
[Abstract] [Full Text] [PDF]

Home page
 Anesth. Analg.Home page
N. R. Connelly, R. K. Parker, T. Lucas, M. El-Mansouri, V. Komanduri, P. Nayak, S. Gutta, C. Gibson, and S. M. Dunn
The Influence of a Bupivacaine and Fentanyl Epidural Infusion After Epidural Fentanyl in Patients Allowed to Ambulate in Early Labor
Anesth. Analg., October 1, 2001; 93(4): 1001 - 1005.
[Abstract] [Full Text] [PDF]

Home page
 Br J AnaesthHome page
J. B. Whiteside and J. A. W. Wildsmith
Developments in local anaesthetic drugs
Br. J. Anaesth., July 1, 2001; 87(1): 27 - 35.
[Abstract] [Full Text] [PDF]

Home page
 Canadian J. AnesthesiaHome page
R. M. Zwack, D. C. Campbell, T. W. Breen, and R. W. Yip
EC80-EC95 OF BUPIV AND ROPIV PLUS FENT FOR LABOUR EPIDURAL ANALGESIA
Can J Anesth, June 1, 2001; 48(90001): A3 - 3.
[Full Text] [PDF]

Home page
 Anesth. Analg.Home page
M. O. Columb, L. S. Polley, and D. C. Campbell
Potencies and Probabilities: One-Sided P Values Suggest a One-Sided Story!
Anesth. Analg., January 1, 2001; 92(1): 278 - 279.
[Full Text] [PDF]

Home page
 Anesth. Analg.Home page
W. Gogarten and H. Van Aken
A Century of Regional Analgesia in Obstetrics
Anesth. Analg., October 1, 2000; 91(4): 773 - 775.
[Full Text] [PDF]


Lippincott, Williams & Wilkins Anesthesia & Analgesia® is published for the International Anesthesia Research Society® by Lippincott Williams & Wilkins with the assistance of Stanford University Libraries' HighWire Press®. Copyright 2006 by the International Anesthesia Research Society. Online ISSN: 1526-7598   Print ISSN: 0003-2999 HighWire Press
Copyright © 2000 by the International Anesthesia Research Society.