title: Epidural butorphanol augments lidocaine sensory anesthesia during labor.
abstract: To determine the efficacy and safety of epidural butorphanol combined with lidocaine, 50 healthy parturients were studied during labor and delivery. All patients received a test dose of 3 ml 1.5% lidocaine with 1:200,000 epinephrine. Patients were then randomly assigned to receive 7 ml of one of two epidural regimens in a double-blind fashion: Group 1 patients received 1.5% lidocaine plus 1 mg butorphanol plus 1:300,000 epinephrine; Group 2 patients received 1.5% lidocaine plus 1:300,000 epinephrine. Each group consisted of 25 patients. The study ended at the time of redosing. All subsequent epidural injections were made with one bolus of plain 0.25% bupivacaine followed by continuous infusion of 0.125% bupivacaine. Duration of anesthesia was significantly longer for Group 1 compared to Group 2 (p less than 0.01), 124 +/- 8 minutes versus 99 +/- 6 minutes (mean +/- SEM). There were no difference between groups in duration of first and second stages of labor, method of delivery or neonatal outcome. Umbilical cord acid-base status and neurologic adaptive capacity scores did not differ significantly between the two groups. The authors conclude that adding small doses of butorphanol to epidural lidocaine during labor is effective and safe.
authors.affiliation: Department of Anesthesiology, Los Angeles County, University of Southern California Medical Center 90033.
authors.forename: T K
authors.initials: TK
authors.lastname: Abboud
authors.forename: J
authors.initials: J
authors.lastname: Zhu
authors.forename: A
authors.initials: A
authors.lastname: Afrasiabi
authors.forename: A
authors.initials: A
authors.lastname: Reyes
authors.forename: G
authors.initials: G
authors.lastname: Sherman
authors.forename: R
authors.initials: R
authors.lastname: Khan
authors.forename: R
authors.initials: R
authors.lastname: Vera Cruz
authors.forename: Z
authors.initials: Z
authors.lastname: Steffens
mesh_terms: D000328:Adult; D015360:Analgesia, Epidural; D016362:Analgesia, Obstetrical; D002077:Butorphanol / Q000008:administration & dosage*; D004311:Double-Blind Method; D004338:Drug Combinations; D004837:Epinephrine / Q000008:administration & dosage; D005260:Female; D006801:Humans; D007743:Labor, Obstetric; D008012:Lidocaine / Q000008:administration & dosage*; D011247:Pregnancy
chemical_list: D004338:Drug Combinations; D008012:Lidocaine; D002077:Butorphanol; D004837:Epinephrine