D. Burke et al., Comparison of 0.25% S(-)-bupivacaine with 0.25% RS-bupivacaine for epidural analgesia in labour, BR J ANAEST, 83(5), 1999, pp. 750-755
Citations number
20
Categorie Soggetti
Aneshtesia & Intensive Care","Medical Research Diagnosis & Treatment
We have compared the efficacy of 0.25% S(-)-bupivacaine with 0.25% RS-bupiv
acaine in providing epidural analgesia for labour in a randomized, multicen
tre, double-blind study. Analgesia was initiated with 10 ml of the study so
lution and maintained with 10-ml top-ups. We studied 137 women and treatmen
ts were found to be equivalent for onset. duration and quality of block Med
ian onset of pain relief was 12 min for both drugs and median duration was
49 (range 3-129) min and 51 (7-157) min for S(-)-bupivacaine and RS bupivac
aine, respectively. The estimated treatment difference for duration of pain
relief was -4 (90% CI -13, 6) min. Thirty patients failed to achieve pain
relief after the first injection (20 patients after S(-)-bupivacaine and 10
after RS-bupivacaine; P=0.039). However, median duration of pain relief fr
om the first top-up was 82 (range 3-164) min for S(-)-bupivacaine and 76 (2
2-221) min for RS-bupivacaine. There were no significant differences in the
quality of analgesia, as assessed by the investigators. There were no sign
ificant differences in the extent of sensory block, percentage of patients
with motor block or incidence of adverse events.