title: [Comparison of levobupivacaine, ropivacaine and racemic bupivacaine in patient-controlled epidural analgesia after cesarean section].
abstract: 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.
authors.affiliation: Department of Anesthesiology, Women and Children's Hospital of Guangzhou, Guangzhou 510180, China.
authors.forename: Yong-fu
authors.initials: YF
authors.lastname: Zhang
authors.forename: Jian-xin
authors.initials: JX
authors.lastname: Lao
authors.forename: Wen-xing
authors.initials: WX
authors.lastname: Liu
authors.forename: Yu
authors.initials: Y
authors.lastname: Li
authors.forename: Guo-zhong
authors.initials: GZ
authors.lastname: Lai
mesh_terms: 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
chemical_list: D000577:Amides; D009020:Morphine; D000077212:Ropivacaine; D000077554:Levobupivacaine; D002045:Bupivacaine