title: Minimum local anaesthetic dose (MLAD) of intrathecal levobupivacaine and ropivacaine for Caesarean section.
abstract: We determined the minimum local anaesthetic dose (MLAD) of spinal levobupivacaine and ropivacaine for Caesarean section. Ninety women were randomly allocated to two groups and received 3 ml of study solution by a combined spinal/epidural technique. The initial dose was 12 mg for levobupivacaine and 17 mg for ropivacaine groups. To be considered effective, a test solution had to achieve a visual analogue pain score (VAPS) of 30 mm or less at skin incision, uterine incision, birth, peritoneal closure, and at the end of surgery. Effective or ineffective responses determined, respectively, a 0.3 mg decrease or increase of the same drug for the next patient in the same group, using up-down sequential allocation. The MLAD of levobupivacaine was 10.58 mg (CI 95%: 10.08-11.09) and the MLAD of ropivacaine 14.22 mg (CI 95%: 13.67-14.77), using the Dixon and Massey formula. The potency ratio between spinal levobupivacaine and spinal ropivacaine was 1.34.
authors.affiliation: Department of Anaesthesia and Intensive Care, Tor Vergata University, Rome, Italy.
authors.forename: R
authors.initials: R
authors.lastname: Parpaglioni
authors.forename: M G
authors.initials: MG
authors.lastname: Frigo
authors.forename: A
authors.initials: A
authors.lastname: Lemma
authors.forename: M
authors.initials: M
authors.lastname: Sebastiani
authors.forename: G
authors.initials: G
authors.lastname: Barbati
authors.forename: D
authors.initials: D
authors.lastname: Celleno
mesh_terms: D000328:Adult; D000577:Amides / Q000008:administration & dosage* / Q000009:adverse effects; D000767:Anesthesia, Epidural / Q000379:methods; D000773:Anesthesia, Obstetrical / Q000379:methods*; D000775:Anesthesia, Spinal / Q000379:methods; D000779:Anesthetics, Local / Q000008:administration & dosage* / Q000009:adverse effects; D002045:Bupivacaine / Q000008:administration & dosage / Q000009:adverse effects / Q000031:analogs & derivatives; D002585:Cesarean Section; D004305:Dose-Response Relationship, Drug; D004812:Epidemiologic Methods; D005260:Female; D006801:Humans; D007022:Hypotension / Q000139:chemically induced; D007431:Intraoperative Complications; D000077554:Levobupivacaine; D010147:Pain Measurement; D011247:Pregnancy; D000077212:Ropivacaine
chemical_list: D000577:Amides; D000779:Anesthetics, Local; D000077212:Ropivacaine; D000077554:Levobupivacaine; D002045:Bupivacaine