The comparison of clinically relevant doses of intrathecal ropivacaine and levobupivacaine with fentanyl for labor analgesia
BackgroundIntrathecal labor analgesia using new local anesthetics such as ropivacaine or levobupivacaine becomes more popular by virtues of their safety and decreased motor weakness. However, the analgesic efficacy of the clinically effective intrathecal doses of these new local anesthetics combined...
| Main Authors: | , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Korean Society of Anesthesiologists
2013-12-01
|
| Series: | Korean Journal of Anesthesiology |
| Subjects: | |
| Online Access: | http://ekja.org/upload/pdf/kjae-65-525.pdf |
| _version_ | 1828834541521862656 |
|---|---|
| author | Kyung-Mi Kim Young Wan Kim Ji Won Choi Ae Ryoung Lee Duck Hwan Choi |
| author_facet | Kyung-Mi Kim Young Wan Kim Ji Won Choi Ae Ryoung Lee Duck Hwan Choi |
| author_sort | Kyung-Mi Kim |
| collection | DOAJ |
| description | BackgroundIntrathecal labor analgesia using new local anesthetics such as ropivacaine or levobupivacaine becomes more popular by virtues of their safety and decreased motor weakness. However, the analgesic efficacy of the clinically effective intrathecal doses of these new local anesthetics combined with fentanyl has yet to be determined.MethodsSixty parturients who requested neuraxial analgesia in early active labor were randomly assigned to either ropivacaine (group R, n = 30) or levobupivacaine (group L, n = 30) group. Group R received 3 mg of intrathecal ropivacaine and the group L received 3 mg of intrathecal levobupivacaine mixed with 20 µg of fentanyl as part of a combined spinal-epidural (CSE) technique. The associated block parameters, such as pain scores, duration of analgesia, the highest levels of the sensory block and motor block scores 30 mins after the injection were compared between two groups.ResultsIntrathecal ropivacaine offered shorter analgesia (87 ± 41 min vs. 122 ± 56 min, P < 0.05) with lower sensory height (T8.5 vs. T6, P < 0.05) and led to lower incidence of complete analgesia (73 vs. 97%, P < 0.05) compared with intrathecal levobupivacaine. Although motor weakness was comparable in both groups, significantly weak perineal squeezing was noticed in Group L (7 of 30 parturients vs. 16 of 30, P < 0.05).ConclusionsClinically relevant doses of intrathecal levobupivacaine in combination with fentanyl as part of a CSE technique provides more effective analgesia than equivalent doses of intrathecal ropivacaine in early labor, but is accompanied by slight motor weakness. |
| first_indexed | 2024-12-12T17:41:36Z |
| format | Article |
| id | doaj.art-0a12b9d1458841da81cacf0506f4f86e |
| institution | Directory Open Access Journal |
| issn | 2005-6419 2005-7563 |
| language | English |
| last_indexed | 2024-12-12T17:41:36Z |
| publishDate | 2013-12-01 |
| publisher | Korean Society of Anesthesiologists |
| record_format | Article |
| series | Korean Journal of Anesthesiology |
| spelling | doaj.art-0a12b9d1458841da81cacf0506f4f86e2022-12-22T00:17:03ZengKorean Society of AnesthesiologistsKorean Journal of Anesthesiology2005-64192005-75632013-12-0165652553010.4097/kjae.2013.65.6.5257715The comparison of clinically relevant doses of intrathecal ropivacaine and levobupivacaine with fentanyl for labor analgesiaKyung-Mi Kim0Young Wan Kim1Ji Won Choi2Ae Ryoung Lee3Duck Hwan Choi4Department of Anesthesiology and Pain Medicine, Hallym University Dongtan Sacred Heart Hospital, Hwaseong, Korea.Department of Anesthesiology and Pain Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.Department of Anesthesiology and Pain Medicine, Daejin Medical Center, Bundang Hospital, Seongnam, Korea.Department of Anesthesiology and Pain Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.Department of Anesthesiology and Pain Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.BackgroundIntrathecal labor analgesia using new local anesthetics such as ropivacaine or levobupivacaine becomes more popular by virtues of their safety and decreased motor weakness. However, the analgesic efficacy of the clinically effective intrathecal doses of these new local anesthetics combined with fentanyl has yet to be determined.MethodsSixty parturients who requested neuraxial analgesia in early active labor were randomly assigned to either ropivacaine (group R, n = 30) or levobupivacaine (group L, n = 30) group. Group R received 3 mg of intrathecal ropivacaine and the group L received 3 mg of intrathecal levobupivacaine mixed with 20 µg of fentanyl as part of a combined spinal-epidural (CSE) technique. The associated block parameters, such as pain scores, duration of analgesia, the highest levels of the sensory block and motor block scores 30 mins after the injection were compared between two groups.ResultsIntrathecal ropivacaine offered shorter analgesia (87 ± 41 min vs. 122 ± 56 min, P < 0.05) with lower sensory height (T8.5 vs. T6, P < 0.05) and led to lower incidence of complete analgesia (73 vs. 97%, P < 0.05) compared with intrathecal levobupivacaine. Although motor weakness was comparable in both groups, significantly weak perineal squeezing was noticed in Group L (7 of 30 parturients vs. 16 of 30, P < 0.05).ConclusionsClinically relevant doses of intrathecal levobupivacaine in combination with fentanyl as part of a CSE technique provides more effective analgesia than equivalent doses of intrathecal ropivacaine in early labor, but is accompanied by slight motor weakness.http://ekja.org/upload/pdf/kjae-65-525.pdfcombined spinal-epidural anesthesiaintrathecal injectionlabor analgesialevobupivacaineropivacaine |
| spellingShingle | Kyung-Mi Kim Young Wan Kim Ji Won Choi Ae Ryoung Lee Duck Hwan Choi The comparison of clinically relevant doses of intrathecal ropivacaine and levobupivacaine with fentanyl for labor analgesia Korean Journal of Anesthesiology combined spinal-epidural anesthesia intrathecal injection labor analgesia levobupivacaine ropivacaine |
| title | The comparison of clinically relevant doses of intrathecal ropivacaine and levobupivacaine with fentanyl for labor analgesia |
| title_full | The comparison of clinically relevant doses of intrathecal ropivacaine and levobupivacaine with fentanyl for labor analgesia |
| title_fullStr | The comparison of clinically relevant doses of intrathecal ropivacaine and levobupivacaine with fentanyl for labor analgesia |
| title_full_unstemmed | The comparison of clinically relevant doses of intrathecal ropivacaine and levobupivacaine with fentanyl for labor analgesia |
| title_short | The comparison of clinically relevant doses of intrathecal ropivacaine and levobupivacaine with fentanyl for labor analgesia |
| title_sort | comparison of clinically relevant doses of intrathecal ropivacaine and levobupivacaine with fentanyl for labor analgesia |
| topic | combined spinal-epidural anesthesia intrathecal injection labor analgesia levobupivacaine ropivacaine |
| url | http://ekja.org/upload/pdf/kjae-65-525.pdf |
| work_keys_str_mv | AT kyungmikim thecomparisonofclinicallyrelevantdosesofintrathecalropivacaineandlevobupivacainewithfentanylforlaboranalgesia AT youngwankim thecomparisonofclinicallyrelevantdosesofintrathecalropivacaineandlevobupivacainewithfentanylforlaboranalgesia AT jiwonchoi thecomparisonofclinicallyrelevantdosesofintrathecalropivacaineandlevobupivacainewithfentanylforlaboranalgesia AT aeryounglee thecomparisonofclinicallyrelevantdosesofintrathecalropivacaineandlevobupivacainewithfentanylforlaboranalgesia AT duckhwanchoi thecomparisonofclinicallyrelevantdosesofintrathecalropivacaineandlevobupivacainewithfentanylforlaboranalgesia AT kyungmikim comparisonofclinicallyrelevantdosesofintrathecalropivacaineandlevobupivacainewithfentanylforlaboranalgesia AT youngwankim comparisonofclinicallyrelevantdosesofintrathecalropivacaineandlevobupivacainewithfentanylforlaboranalgesia AT jiwonchoi comparisonofclinicallyrelevantdosesofintrathecalropivacaineandlevobupivacainewithfentanylforlaboranalgesia AT aeryounglee comparisonofclinicallyrelevantdosesofintrathecalropivacaineandlevobupivacainewithfentanylforlaboranalgesia AT duckhwanchoi comparisonofclinicallyrelevantdosesofintrathecalropivacaineandlevobupivacainewithfentanylforlaboranalgesia |