[Comparison of levobupivacaine, ropivacaine and racemic bupivacaine in patient-controlled epidural analgesia after cesarean section].
OBJECTIVE
To compare efficacy and side effects of patient-controlled epidural analgesia (PCEA) with levobupivacaine, ropivacaine and racemic bupivacaine after cesarean section.


METHODS
In this prospective, randomized double-blind study, 90 ASA I-II full-term nulliparous women (aged 25-38 years with body weight of 59-87 kg) undergoing elective cesarean section under spinal-epidural anesthesia equally allocated into 3 groups. PCEA was administered with 0.125% levobupivacaine and 20 microg/ml morphine (group L, n=30), 0.125% ropivacaine and 20 microg/ml morphine (group R, n=30), and 0.125% bupivacaine and 20 microg/ml morphine (group B, n=30), respectively. The Visual Analog Scale (VAS) score, satisfaction rate, patients' overall impression of treatment, modified Bromage motor score, and incidence of side effects were recorded at regular intervals after operation.


RESULTS
The three groups were comparable with respect to the efficacy of analgesia, patients' overall impression of treatment, motor blockade and side effects. There was significant difference in patients' satisfaction rate between group R (70%) and the other two groups (93.3% in group L and 96.6% in group B, P<0.05).


CONCLUSIONS
PCEA with 0.125% levobupivacaine and morphine 20 microg/ml produces better analgesic effect with little side effects after cesarean section.
Zhang
Yong-fu
YF
Department of Anesthesiology, Women and Children's Hospital of Guangzhou, Guangzhou 510180, China.
Lao
Jian-xin
JX
Liu
Wen-xing
WX
Li
Yu
Y
Lai
Guo-zhong
GZ
D000328:Adult; D000577:Amides / Q000008:administration & dosage* / Q000009:adverse effects; D015360:Analgesia, Epidural; D016362:Analgesia, Obstetrical; D016058:Analgesia, Patient-Controlled; D002045:Bupivacaine / Q000008:administration & dosage* / Q000009:adverse effects / Q000031:analogs & derivatives; D002585:Cesarean Section; D004311:Double-Blind Method; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D000077554:Levobupivacaine; D009020:Morphine / Q000008:administration & dosage; D009325:Nausea / Q000139:chemically induced; D011247:Pregnancy; D011446:Prospective Studies; D011537:Pruritus / Q000139:chemically induced; D000077212:Ropivacaine; D016896:Treatment Outcome; D014839:Vomiting / Q000139:chemically induced
D000577:Amides; D009020:Morphine; D000077212:Ropivacaine; D000077554:Levobupivacaine; D002045:Bupivacaine