title: Comparison of 0.125% bupivacaine with 0.125% bupivacaine and clonidine as extradural analgesia in the first stage of labour.
abstract: We have studied 42 healthy parturients with singleton vertex pregnancies, who were in the first stage of labour and requesting extradural analgesia. They were allocated randomly in a double-blind fashion to receive either 0.125% bupivacaine plain or 0.125% bupivacaine with clonidine 120 micrograms. Efficacy of analgesia was evaluated using linear visual analogue scoring (VAS), sensory block was assessed using bilateral pinprick in the mid-clavicular line and sedation scored on a five-point scale. Maternal and fetal cardiovascular variables were measured every 2 min for 20 min, at 30 min and subsequently at 15-min intervals. The reduction in VAS was greater at all times in the bupivacaine-clonidine group (P < 0.01). The median (range) duration of analgesia was greater in the bupivacaine-clonidine group (114.5 (30-243) min) compared with the bupivacaine group (53 (30-100) min) (P < 0.001). Analgesia was associated with a reduction in arterial pressure in both groups, but there were no between-group differences. Maternal heart rate was less than baseline values at 30-90 min in the bupivacaine-clonidine group only. Sedation was greater in the bupivacaine-clonidine group, especially from 15 to 45 min (P < 0.01). There were no differences in fetal heart rate, mode of delivery or Apgar scores between the two groups.
authors.affiliation: Department of Anaesthesia and Intensive Care, Chinese University of Hong Kong, Prince of Wales Hospital, Sha Tin.
authors.forename: M E
authors.initials: ME
authors.lastname: O'Meara
authors.forename: T
authors.initials: T
authors.lastname: Gin
mesh_terms: D000293:Adolescent; D000328:Adult; D015360:Analgesia, Epidural; D016362:Analgesia, Obstetrical; D001034:Apgar Score; D001794:Blood Pressure / Q000187:drug effects; D002045:Bupivacaine / Q000008:administration & dosage*; D003000:Clonidine / Q000008:administration & dosage*; D036861:Delivery, Obstetric; D004311:Double-Blind Method; D005260:Female; D006339:Heart Rate / Q000187:drug effects; D006801:Humans; D007747:Labor Stage, First; D010147:Pain Measurement; D011247:Pregnancy; D013997:Time Factors
chemical_list: D003000:Clonidine; D002045:Bupivacaine