COMPARISON OF 0.125-PERCENT BUPIVACAINE WITH 0.125-PERCENT BUPIVACAINE AND CLONIDINE AS EXTRADURAL ANALGESIA IN THE 1ST STAGE OF LABOR

We have studied 42 healthy paturients with single-ton vertex pregnanci es, who were in the first stage of labour and requesting extradural an algesia. They were allocated randomly in a double-blind fashion to rec eive either 0.125% bupivacaine plain or 0.125% bupivacaine with clonid ine 120 mug. Efficacy of analgesia was evaluated using linear visual a nalogue scoring (VAS), sensory block was assessed using bilateral pinp rick in the mid-clavicular line and sedation scored on a five-point sc ale. Maternal and fetal cardiovascular variables were measured every 2 min for 20 min, at 30 min and subsequently at 15-min intervals. The r eduction in VAS was greater at all times in the bupivacaine-clonidine group (P < 0.01). The median (range) duration of analgesia was greater in the bupivacaine-clonidine group (114.5 (30-243) min) compared with the bupivacaine group (53 (30-100) min) (P < 0.001). Analgesia was as sociated with a reduction in arterial pressure in both groups, but the re were no between-group differences. Maternal heart rate was less tha n baseline values at 30-90 min in the bupivacaine-clonidine group only . Sedation was greater in the bupivacaine-clonidine group, especially from 15 to 45 min (P < 0.01). There were no differences in fetal heart rate, mode of delivery or Apgar scores between the two groups.