0.2% Ropivacaine and levobupivacaine provide equally effective epidural labour analgesia.
OBJECTIVE
To compare the duration of epidural analgesia induced by levobupivacaine and ropivacaine at clinically relevant doses.


METHODS
Forty healthy nulliparous parturients with cervical dilatation of 3 to 5 cm and at least one contraction every two or three minutes were recruited. Patients were randomly assigned to receive either 10 mL of 0.2% ropivacaine or 10 mL of 0.2% levobupivacaine. Preblock visual analogue scale (VAS) score (0-100) and VAS score after five, ten, 15, 20, 25 and 30 min from time(0) and VAS at time of request for additional analgesia (time(end)) were recorded. During the first 30 min after the completion of epidural injection, the systolic blood pressure, highest sensory level to cold and the maximum degree of motor block based on a 0 to 3 modified Bromage scale were collected every five minutes. The duration of analgesia was defined as the time from time(0) to time(end).


RESULTS
There was no difference in the duration of analgesia between the two groups; similarly, there was no significant difference found in the area under the curve (AUC) time(15)-time(0) and AUC time(30)-time(0) for VAS. The highest sensory block to cold and the degree of motor block were also indistinguishable between the two groups. No difference in the serial systolic blood pressures was found.


CONCLUSIONS
Ten millilitres of either 0.2% ropivacaine or levobupivacaine can be used to induce epidural labour analgesia effectively without a difference in the duration of pain relief.
Supandji
Mia
M
Department of Anesthesia O & G, KK Women and Children Hospital, 100 Bukit Timah Road, Singapore. athsia@kkh.com.sg
Sia
Alex T H
AT
Ocampo
Cecilia E
CE
D000328:Adult; D000577:Amides / Q000008:administration & dosage*; D015360:Analgesia, Epidural; D016362:Analgesia, Obstetrical; D000779:Anesthetics, Local / Q000008:administration & dosage*; D019540:Area Under Curve; D001794:Blood Pressure / Q000187:drug effects; D002045:Bupivacaine / Q000008:administration & dosage* / Q000031:analogs & derivatives; D003080:Cold Temperature; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D048949:Labor Pain / Q000188:drug therapy; D007743:Labor, Obstetric; D000077554:Levobupivacaine; D009046:Motor Neurons / Q000187:drug effects; D010147:Pain Measurement; D011247:Pregnancy; D000077212:Ropivacaine; D012677:Sensation / Q000187:drug effects; D013997:Time Factors
D000577:Amides; D000779:Anesthetics, Local; D000077212:Ropivacaine; D000077554:Levobupivacaine; D002045:Bupivacaine