‘Walking epidural’: comparison of the analgesic efficacy of levobupivacaine 0.0625% + fentanyl 2mcg/mL versus ropivacaine 0.075% + fentanyl 2mcg/mL
Abstract Introduction Epidural infusion with low local anesthetic concentrations with opiates decrease the severity of the motor blockade associated. The present study aims to compare the analgesic efficacy and the motor blockade between two local anesthetic epidural infusions: levobupivacaine 0.062...
| Main Authors: | , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
BMC
2023-08-01
|
| Series: | BMC Anesthesiology |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12871-023-02222-w |
| _version_ | 1797752600452399104 |
|---|---|
| author | Álvaro Mingote Eloísa Zamora Moreno Andrés García Díaz Guillermo Chiara Graciani Carlos Elbal Sánchez Cristina Guadalix Sánchez Diego Gutiérrez Martínez Javier García - Fernández Inocencia Fornet Ruiz |
| author_facet | Álvaro Mingote Eloísa Zamora Moreno Andrés García Díaz Guillermo Chiara Graciani Carlos Elbal Sánchez Cristina Guadalix Sánchez Diego Gutiérrez Martínez Javier García - Fernández Inocencia Fornet Ruiz |
| author_sort | Álvaro Mingote |
| collection | DOAJ |
| description | Abstract Introduction Epidural infusion with low local anesthetic concentrations with opiates decrease the severity of the motor blockade associated. The present study aims to compare the analgesic efficacy and the motor blockade between two local anesthetic epidural infusions: levobupivacaine 0.0625% + fentanyl 2mcg/mL versus ropivacaine 0.075% + fentanyl 2mcg/mL. Materials and methods In a single-blind prospective randomized study, 60 laboring parturient had continuous epidural analgesia as follows: 30 of them received levobupivacaine 0.0625% + fentanyl 2mcg/mL and 30 of them received ropivacaine 0.075% + fentanyl 2mcg/mL and rates of infusion were adjusted to the height. Analgesic, motor blockade and satisfaction records were collected as well as maternal and neonate adverse events. Results After 2 h of the catheter placement, patients who received levobupivacaine showed a mean VAS of 3.2 [1.8–4.6] versus 1.8 [1.2–2.5] (p = 0.05) in patients who received ropivacaine. In addition, patients who received levobupivacaine showed a punctuation in Bromage scale of 0.0 [0.0–1.0] versus 0.0 [0.0–0.0] (p = 0.04) in patients who received ropivacaine. Finally, the parturient who received levobupivacaine scored a mean satisfaction index of 8.1 [7.3–8.9] versus 9.3 [8.7–9.8] (p = 0.02) in those who received ropivacaine. We did not register maternal nor neonate adverse events. Conclusion Both infusions (levobupivacaine 0.0625% + fentanyl 2mcg/mL and ropivacaine 0.075% + fentanyl 2mcg/mL) are effective for labor analgesia. However, ropivacaine would present a better pharmacodynamic profile with less motor blockade and decreased need for analgesic rescue hence improving patient’s satisfaction. |
| first_indexed | 2024-03-12T17:06:47Z |
| format | Article |
| id | doaj.art-147db4d0b5374af6952b5b9d0a337fc3 |
| institution | Directory Open Access Journal |
| issn | 1471-2253 |
| language | English |
| last_indexed | 2024-03-12T17:06:47Z |
| publishDate | 2023-08-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Anesthesiology |
| spelling | doaj.art-147db4d0b5374af6952b5b9d0a337fc32023-08-06T11:23:15ZengBMCBMC Anesthesiology1471-22532023-08-012311510.1186/s12871-023-02222-w‘Walking epidural’: comparison of the analgesic efficacy of levobupivacaine 0.0625% + fentanyl 2mcg/mL versus ropivacaine 0.075% + fentanyl 2mcg/mLÁlvaro Mingote0Eloísa Zamora Moreno1Andrés García Díaz2Guillermo Chiara Graciani3Carlos Elbal Sánchez4Cristina Guadalix Sánchez5Diego Gutiérrez Martínez6Javier García - Fernández7Inocencia Fornet Ruiz 8Anesthesia, Critical Care Department and Pain Unit, Puerta de Hierro Universitary HospitalAnesthesia, Critical Care Department and Pain Unit, Puerta de Hierro Universitary HospitalAnesthesia, Critical Care Department and Pain Unit, Puerta de Hierro Universitary HospitalAnesthesia, Critical Care Department and Pain Unit, Puerta de Hierro Universitary HospitalAnesthesia, Critical Care Department and Pain Unit, Puerta de Hierro Universitary HospitalAnesthesia, Critical Care Department and Pain Unit, Puerta de Hierro Universitary HospitalAnesthesia, Critical Care Department and Pain Unit, Puerta de Hierro Universitary HospitalAnesthesia, Critical Care Department and Pain Unit, Puerta de Hierro Universitary HospitalAnesthesia, Critical Care Department and Pain Unit, Puerta de Hierro Universitary HospitalAbstract Introduction Epidural infusion with low local anesthetic concentrations with opiates decrease the severity of the motor blockade associated. The present study aims to compare the analgesic efficacy and the motor blockade between two local anesthetic epidural infusions: levobupivacaine 0.0625% + fentanyl 2mcg/mL versus ropivacaine 0.075% + fentanyl 2mcg/mL. Materials and methods In a single-blind prospective randomized study, 60 laboring parturient had continuous epidural analgesia as follows: 30 of them received levobupivacaine 0.0625% + fentanyl 2mcg/mL and 30 of them received ropivacaine 0.075% + fentanyl 2mcg/mL and rates of infusion were adjusted to the height. Analgesic, motor blockade and satisfaction records were collected as well as maternal and neonate adverse events. Results After 2 h of the catheter placement, patients who received levobupivacaine showed a mean VAS of 3.2 [1.8–4.6] versus 1.8 [1.2–2.5] (p = 0.05) in patients who received ropivacaine. In addition, patients who received levobupivacaine showed a punctuation in Bromage scale of 0.0 [0.0–1.0] versus 0.0 [0.0–0.0] (p = 0.04) in patients who received ropivacaine. Finally, the parturient who received levobupivacaine scored a mean satisfaction index of 8.1 [7.3–8.9] versus 9.3 [8.7–9.8] (p = 0.02) in those who received ropivacaine. We did not register maternal nor neonate adverse events. Conclusion Both infusions (levobupivacaine 0.0625% + fentanyl 2mcg/mL and ropivacaine 0.075% + fentanyl 2mcg/mL) are effective for labor analgesia. However, ropivacaine would present a better pharmacodynamic profile with less motor blockade and decreased need for analgesic rescue hence improving patient’s satisfaction.https://doi.org/10.1186/s12871-023-02222-wWalking epiduralLevobupivacaineRopivacaineFentanylLabor |
| spellingShingle | Álvaro Mingote Eloísa Zamora Moreno Andrés García Díaz Guillermo Chiara Graciani Carlos Elbal Sánchez Cristina Guadalix Sánchez Diego Gutiérrez Martínez Javier García - Fernández Inocencia Fornet Ruiz ‘Walking epidural’: comparison of the analgesic efficacy of levobupivacaine 0.0625% + fentanyl 2mcg/mL versus ropivacaine 0.075% + fentanyl 2mcg/mL BMC Anesthesiology Walking epidural Levobupivacaine Ropivacaine Fentanyl Labor |
| title | ‘Walking epidural’: comparison of the analgesic efficacy of levobupivacaine 0.0625% + fentanyl 2mcg/mL versus ropivacaine 0.075% + fentanyl 2mcg/mL |
| title_full | ‘Walking epidural’: comparison of the analgesic efficacy of levobupivacaine 0.0625% + fentanyl 2mcg/mL versus ropivacaine 0.075% + fentanyl 2mcg/mL |
| title_fullStr | ‘Walking epidural’: comparison of the analgesic efficacy of levobupivacaine 0.0625% + fentanyl 2mcg/mL versus ropivacaine 0.075% + fentanyl 2mcg/mL |
| title_full_unstemmed | ‘Walking epidural’: comparison of the analgesic efficacy of levobupivacaine 0.0625% + fentanyl 2mcg/mL versus ropivacaine 0.075% + fentanyl 2mcg/mL |
| title_short | ‘Walking epidural’: comparison of the analgesic efficacy of levobupivacaine 0.0625% + fentanyl 2mcg/mL versus ropivacaine 0.075% + fentanyl 2mcg/mL |
| title_sort | walking epidural comparison of the analgesic efficacy of levobupivacaine 0 0625 fentanyl 2mcg ml versus ropivacaine 0 075 fentanyl 2mcg ml |
| topic | Walking epidural Levobupivacaine Ropivacaine Fentanyl Labor |
| url | https://doi.org/10.1186/s12871-023-02222-w |
| work_keys_str_mv | AT alvaromingote walkingepiduralcomparisonoftheanalgesicefficacyoflevobupivacaine00625fentanyl2mcgmlversusropivacaine0075fentanyl2mcgml AT eloisazamoramoreno walkingepiduralcomparisonoftheanalgesicefficacyoflevobupivacaine00625fentanyl2mcgmlversusropivacaine0075fentanyl2mcgml AT andresgarciadiaz walkingepiduralcomparisonoftheanalgesicefficacyoflevobupivacaine00625fentanyl2mcgmlversusropivacaine0075fentanyl2mcgml AT guillermochiaragraciani walkingepiduralcomparisonoftheanalgesicefficacyoflevobupivacaine00625fentanyl2mcgmlversusropivacaine0075fentanyl2mcgml AT carloselbalsanchez walkingepiduralcomparisonoftheanalgesicefficacyoflevobupivacaine00625fentanyl2mcgmlversusropivacaine0075fentanyl2mcgml AT cristinaguadalixsanchez walkingepiduralcomparisonoftheanalgesicefficacyoflevobupivacaine00625fentanyl2mcgmlversusropivacaine0075fentanyl2mcgml AT diegogutierrezmartinez walkingepiduralcomparisonoftheanalgesicefficacyoflevobupivacaine00625fentanyl2mcgmlversusropivacaine0075fentanyl2mcgml AT javiergarciafernandez walkingepiduralcomparisonoftheanalgesicefficacyoflevobupivacaine00625fentanyl2mcgmlversusropivacaine0075fentanyl2mcgml AT inocenciafornetruiz walkingepiduralcomparisonoftheanalgesicefficacyoflevobupivacaine00625fentanyl2mcgmlversusropivacaine0075fentanyl2mcgml |