Labor analgesia with ropivacaine added to clonidine: a randomized clinical trial.
OBJECTIVE
Previous studies have led to speculation that the association between ropivacaine and clonidine might be more effective than ropivacaine alone. We examined the maternal-fetal effects of two pharmacological approaches: a low dose of ropivacaine or a lower dose of ropivacaine plus clonidine for epidural analgesia during labor.


METHODS
Prospective study at Department of Anesthesiology, Faculdade de Medicina de Botucatu, Universidade Estadual Paulista.


METHODS
Thirty-two pregnant women in American Society of Anesthesiologists physical status I and II randomly underwent epidural analgesia using 15 ml of ropivacaine 0.125% (R group) or 15 ml of ropivacaine 0.0625% plus 75 microg clonidine (RC group). Pain intensity, sensory block level, latency time, motor block intensity, duration of labor analgesia and duration of epidural analgesia were evaluated. The newborns were evaluated using Apgar scores and the Amiel-Tison method (neurological and adaptive capacity score).


RESULTS
There were no statistically significant differences between the groups regarding pain score, sensory block level, duration of epidural analgesia or Apgar score. The latency time, duration of labor analgesia and motor block were R group < RC group. The half-hour and two-hour neurological and adaptive capacity scores were higher in the R group. All of the R group newborns and 75% of the RC group newborns were found to be neurologically healthy at the 24-hour examination.


RESULTS
There were no statistically significant differences between the groups regarding pain score, sensory block level, duration of epidural analgesia or Apgar score. The latency time, duration of labor analgesia and motor block were R group < RC group. The half-hour and two-hour neurological and adaptive capacity scores were higher in the R group. All of the R group newborns and 75% of the RC group newborns were found to be neurologically healthy at the 24-hour examination.


CONCLUSIONS
Both low-dose ropivacaine and a lower dose plus clonidine relieved maternal pain during obstetric labor. Newborns of mothers who received only ropivacaine showed better neurological and adaptive capacity scores.
Nakamura
Giane
G
Hospital das Clínicas, Faculdade de Medicina de Botucatu, Universidade Estadual Paulista, Botucatu, São Paulo, Brazil.
Ganem
Eliana Marisa
EM
Módolo
Norma Sueli Pinheiro
NS
Rugolo
Ligia Maria Suppo de Souza
LM
Castiglia
Yara Marcondes Machado
YM
D000328:Adult; D000577:Amides / Q000008:administration & dosage*; D015360:Analgesia, Epidural; D016362:Analgesia, Obstetrical; D000700:Analgesics / Q000008:administration & dosage*; D000779:Anesthetics, Local / Q000008:administration & dosage*; D001034:Apgar Score; D003000:Clonidine / Q000008:administration & dosage*; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D007022:Hypotension / Q000139:chemically induced; D007231:Infant, Newborn; D007743:Labor, Obstetric; D009046:Motor Neurons / Q000187:drug effects; D010147:Pain Measurement / Q000187:drug effects; D011247:Pregnancy; D011446:Prospective Studies; D000077212:Ropivacaine; D055815:Young Adult
D000577:Amides; D000700:Analgesics; D000779:Anesthetics, Local; D000077212:Ropivacaine; D003000:Clonidine