title: Diamorphine-bupivacaine mixture compared with plain bupivacaine for analgesia.
abstract: We have studied the efficacy of two extradural infusions (10 ml h-1) in 50 patients in active labour. Patients in the diamorphine group (n = 25) received 0.0625% plain bupivacaine 6.25 mg h-1 mixed with 0.005% diamorphine 0.5 mg h-1 and those in the control group (n = 25) received 0.125% plain bupivacaine 12.5 mg h-1. Both groups received intermittent "top-ups" of 0.25% bupivacaine 10 ml when indicated. Although median pain scores during the infusion were similar in both groups, patients in the diamorphine group indicated greater satisfaction with the infusion (88% very satisfied, compared with 52% in the control group (P < 0.02)). There were no differences in the incidence of hypotension, instrumental vaginal delivery, number of "top-ups", duration of the second stage or extent of motor block. However, patients in the diamorphine group had a high incidence of pruritus (44%, compared with 0% in the control group (P < 0.01)).
authors.affiliation: Department of Anaesthetics, St Georges Hospital, London.
authors.forename: C R
authors.initials: CR
authors.lastname: Bailey
authors.forename: R
authors.initials: R
authors.lastname: Ruggier
authors.forename: I L
authors.initials: IL
authors.lastname: Findley
mesh_terms: D000293:Adolescent; D000328:Adult; D015360:Analgesia, Epidural; D016362:Analgesia, Obstetrical; D002045:Bupivacaine; D036861:Delivery, Obstetric; D004311:Double-Blind Method; D004338:Drug Combinations; D005260:Female; D003932:Heroin / Q000009:adverse effects; D006801:Humans; D010147:Pain Measurement / Q000187:drug effects; D011247:Pregnancy; D011537:Pruritus / Q000139:chemically induced
chemical_list: D004338:Drug Combinations; D003932:Heroin; D002045:Bupivacaine