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OBSTETRIC ANESTHESIA

A Comparison of 0.0625% Bupivacaine with Fentanyl and 0.1% Ropivacaine with Fentanyl for Continuous Epidural Labor Analgesia

Department of Anesthesiology and Critical Care, Anesthesia Unit, Fundación Hospital Alcorcón; Alcorcón, Madrid, Spain

Address correspondence and reprint requests to Jaime Fernández-Guisasola, MD, Anesthesia Unit, Fundación Hospital Alcorcón, Avda. Budapest 1, 28922 Alcorcón, Madrid. Spain. Address e-mail to jfguisasola{at}fhalcorcon.es

We compared the analgesic efficacy and the degree of motor block achieved with epidural infusion of 0.0625% bupivacaine (Group B) versus 0.1% ropivacaine (Group R), both with 0.0002% fentanyl (2 µg/mL) in laboring patients. A prospective, double-blinded study was performed in 98 ASA physical status I-II parturients who were divided randomly into two groups to receive either bupivacaine or ropivacaine after catheter location had been tested with an initial bolus of lidocaine and fentanyl. The infusion rate was 15 mL/h in every case. When pain was perceived, 5-mL boluses of the assigned epidural analgesic were administered every 10 min until analgesia was achieved. We recorded pain intensity, level of sensory block, degree of motor block, hemodynamic variables, secondary effects, mode of delivery, neonatal outcome, and patient satisfaction. There were no statistically significant differences in any of the factors analyzed. Highly effective analgesia was achieved in both groups with a small incidence of motor block. These findings suggest that bupivacaine may be more potent than ropivacaine.

Implications: We compared different concentrations of epidural bupivacaine and ropivacaine thought to be equipotent. Both solutions were equally efficient in providing highly effective epidural analgesia for labor with minimal motor block. These findings suggest that bupivacaine may be more potent than ropivacaine.

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