Focused review: ropivacaine versus bupivacaine for epidural labor analgesia.
Neuraxial analgesia is frequently administered to women in labor. For many years, bupivacaine has been used because of its long duration of action, lack of excessive motor block, and minimal fetal and neonatal effects. However, bupivacaine is one of the most cardiotoxic local anesthetics in current use and motor block is still a problem. Many local anesthetics such as bupivacaine exist in 2 forms, levorotatory and dextrorotatory. Ropivacaine, an amide local anesthetic produced in the pure levorotatory form addresses some of the concerns related to bupivacaine. In this article, we present the literature comparing ropivacaine and bupivacaine to determine whether there is an advantage to using one of these local anesthetics for labor analgesia. We found that there is no advantage to the routine use of ropivacaine for labor analgesia.
Department of Anesthesiology, The Mount Sinai Medical Center, One Gustave L. Levy Place, New York, NY 10029-6574, USA. Yaakov.beilin@mountsinai.or
Yaakov
Y
Beilin
Stephen
S
Halpern
D000577:Amides / Q000008:administration & dosage* / Q000009:adverse effects / Q000191:economics; D015360:Analgesia, Epidural / Q000009:adverse effects / Q000191:economics / Q000379:methods*; D016362:Analgesia, Obstetrical / Q000009:adverse effects / Q000191:economics / Q000379:methods*; D000779:Anesthetics, Local / Q000008:administration & dosage* / Q000009:adverse effects / Q000191:economics; D000818:Animals; D002045:Bupivacaine / Q000008:administration & dosage* / Q000009:adverse effects / Q000191:economics; D003257:Consumer Product Safety; D003362:Cost-Benefit Analysis; D004305:Dose-Response Relationship, Drug; D016527:Drug Costs; D019317:Evidence-Based Medicine; D005260:Female; D006801:Humans; D048949:Labor Pain / Q000188:drug therapy*; D009043:Motor Activity / Q000187:drug effects; D011247:Pregnancy; D018570:Risk Assessment; D000077212:Ropivacaine; D016896:Treatment Outcome
D000577:Amides; D000779:Anesthetics, Local; D000077212:Ropivacaine; D002045:Bupivacaine