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Anaesthesia


Title:Continuous patient-controlled epidural infusion of levobupivacaine plus sufentanil in labouring primiparous women: effects of concentration
Author(s):Tixier, S. Bonnin, M. Bolandard, F. Vernis, L. Lavergne, B. Bazin, J. E. Duale, C.
Address:CHU Clermont-Ferrand, Pole Anesthesie-Reanimation-Hotel-Dieu, Polyclinique, France.
Year:2010 Jun
Journal Title:Anaesthesia
Page Number:573-80
Language:eng
Volume:65
Issue:6
ISSN/ISBN:1365-2044 (Electronic). 0003-2409 (Linking)
Abstract:The 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 x ml(-1) levobupivacaine (low concentration group) or 1.136 mg x ml(-1) levobupivacaine (high concentration group), with sufentanil 0.45 microg x 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 x h(-1). Analgesia was found to be more efficacious in the high-concentration group. The dose of levobupivacaine administered was higher and sometimes overstepping recommended limits in the high concentration group, but with no observed increase in side-effects. The choice between these two concentrations may still be made according to the patient's and the practitioner's preferences. The effects of an intermediate concentration should be studied in the future.

 
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