[0.0625% bupivacaine compared with 0.125% bupivacaine continuously perfused epidurally during vaginal delivery].
BACKGROUND
The effects of two continuous epidural perfusions of bupivacaine at different small concentrations on maternal analgesia, motor paralysis, the progress of delivery and the newborn were compared.


METHODS
Forty primigravida patients were divided into two homogeneous groups, A and B, with 20 patients in each. Group A patients were administered a perfusion of bupivacaine at 0.625% and those of group B received a perfusion of bupivacaine at 0.125%. Both perfusions were administered at 10 mg/hour. The following variables were collected: analgesia (visual analogic scale), time of perfusion, local anesthetic doses, re-injections, tenesmus, APGAR at the first minute, APGAR at 5 minutes, use of forceps and motor paralysis.


RESULTS
The perfusion of bupivacaine 0.125% (group B) was more effective in the control of pain since no re-injections were required in this group. The time of perfusion and delivery was significantly less (p < 0.05) in group B (2.95 +/- 0.74 hours) than in group A (3.42 +/- 0.62 hours). There were no significant differences in the total dose (group A: 55.9 +/- 14.09 mg and group B 57.47 +/- 9.06 mg), tenesmus and APGAR: Instrumentation during delivery carried out in both groups (55% in group A and 30% in group B) was at the limits of significance (p = 0.057). Motor paralysis of the lower limbs did not surpass the value of 1 of the modified Bromage scale in either group.


CONCLUSIONS
Both techniques (continuous perfusion of bupivacaine at 0.0625% versus bupivacaine at 0.125%) are effective in the control of pain during the second stage of labour with the perfusion of the latter dose (12.5 mg/hour) being more advantageous by diminishing the length of delivery and achieving continuous analgesia.
Sánchez-Pereles
M C
MC
Servicio de Anestesiología y Reanimación, Hospital Universitario Nuestra Señora de Valme, Sevilla.
Uribarri
F J
FJ
Gragera
I
I
D000293:Adolescent; D000328:Adult; D015360:Analgesia, Epidural; D016362:Analgesia, Obstetrical; D001034:Apgar Score; D002045:Bupivacaine / Q000008:administration & dosage*; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D011247:Pregnancy
D002045:Bupivacaine
Bupivacaína al 0.0625% comparada con bupivacaína al 0.125% en perfusión continua por vía epidural en parto vaginal.