The effect of pH-adjusted 2-chloroprocaine on the duration and quality of pain relief with a subsequent continuous epidural bupivacaine infusion.
A randomized, double-blind true experimental design with a post-test only was chosen to determine if the addition of sodium bicarbonate to 2-chloroprocaine would result in a longer duration of epidural analgesia, as well as increase the quality of pain relief in stage I parturients receiving a continuous bupivacaine epidural infusion. The experimental group (number (N) = 16) received sodium bicarbonate and 2-chloroprocaine followed by a continuous bupivacaine epidural infusion. The control group (N = 15) received normal saline and 2-chloroprocaine followed by a continuous bupivacaine epidural infusion. Only ASA I or II patients in stage I labor were included in this study. Measures of pain perception were made using a self-report, visual analog scale. Measures also were made of the quality and duration of block over time, the intensity of motor block over time, and the blood pressure over time. The cephalad dermatome level of analgesia was determined by pinprick. A record of the need for a supplemental bolus of local anesthetic to maintain a sensory level of T-10 was also recorded. The mean self-perceived level of pain was significantly different for the two groups (P = .024). Moreover, the pattern of self-perceived level of pain over time differs for the two groups in a significant way (P = .023). Additional bolus injections occurred nine times in the control group and six times in the experimental group. The differences were not found to be significant (P > .106). The differences in time and amount of local anesthetic delivered were also found to be trivial (P > .80).(ABSTRACT TRUNCATED AT 250 WORDS)
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D000767:Anesthesia, Epidural / Q000592:standards*; D000773:Anesthesia, Obstetrical / Q000592:standards*; D000779:Anesthetics, Local / Q000008:administration & dosage / Q000627:therapeutic use*; D002045:Bupivacaine / Q000008:administration & dosage / Q000627:therapeutic use*; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D006863:Hydrogen-Ion Concentration; D007744:Obstetric Labor Complications / Q000188:drug therapy; D010146:Pain / Q000188:drug therapy; D011247:Pregnancy; D011343:Procaine / Q000008:administration & dosage / Q000031:analogs & derivatives* / Q000627:therapeutic use
D000779:Anesthetics, Local; D011343:Procaine; C004616:chloroprocaine; D002045:Bupivacaine