title: Effect of position on the spread of buffered 2% chloroprocaine administered epidurally for the second stage of labor.
abstract: Increasing the pH of epidurally administered local anesthetics hastens their onset of action and improves the quality of neural blockade. The effect of body position on the epidural spread of alkalinized 2% chloroprocaine HCl for the second stage of labor has not been reported. We studied the epidural cephalad and caudad spread of 2% chloroprocaine buffered with sodium bicarbonate administered epidurally at the beginning of the second stage of labor. We randomly assigned 30 patients to one of two groups, each consisting of 15 patients. Group 1 received an epidural redose in the upright position, and the patients in group 2 received a redose in the supine position. There were no differences with respect to the sacral or cephalad spread. From the results of this study, we conclude that patients may receive epidurally administered 2% chloroprocaine late during the first stage of labor while in a supine position.
authors.affiliation: Department of Anesthesia, University of Cincinnati College of Medicine, Ohio 45267-0531.
authors.forename: W E
authors.initials: WE
authors.lastname: Ackerman
authors.forename: J A
authors.initials: JA
authors.lastname: Herold
authors.forename: M M
authors.initials: MM
authors.lastname: Juneja
authors.forename: N J
authors.initials: NJ
authors.lastname: Sweeney
mesh_terms: D000328:Adult; D000767:Anesthesia, Epidural / Q000379:methods; D000773:Anesthesia, Obstetrical / Q000379:methods; D000779:Anesthetics, Local; D001639:Bicarbonates / Q000627:therapeutic use; D002021:Buffers; D005260:Female; D006801:Humans; D006863:Hydrogen-Ion Concentration; D007748:Labor Stage, Second; D007743:Labor, Obstetric; D011187:Posture; D011247:Pregnancy; D011343:Procaine / Q000031:analogs & derivatives*; D011897:Random Allocation; D012964:Sodium / Q000627:therapeutic use; D017693:Sodium Bicarbonate; D013484:Supination
chemical_list: D000779:Anesthetics, Local; D001639:Bicarbonates; D002021:Buffers; D011343:Procaine; C004616:chloroprocaine; D017693:Sodium Bicarbonate; D012964:Sodium