title: Addition of clonidine to a continuous patient-controlled epidural infusion of low-concentration levobupivacaine plus sufentanil in primiparous women during labour.
abstract: We studied the potentiation of analgesia for labour by the addition of clonidine to epidural low-concentration levobupivacaine with sufentanil in a randomised, double-blinded study. We enrolled primiparous women who were in spontaneous labour. The study solutions, made of 100 ml levobupivacaine 0.0625% plus sufentanil 0.45 μg.ml(-1) and either 150 μg clonidine or no clonidine, were used for induction of analgesia, and for its maintenance with self-administered boluses and a continuous background infusion. The need for additional epidural boluses during labour was lower and analgesia and maternal satisfaction were better in the clonidine (n = 57) than in the control group (n = 58). Blood pressure was lower and the rate of instrumental delivery higher in the clonidine group. Clonidine (1.36 μg.ml(-1)) added to the epidural solution of low-concentration levobupivacaine improves the quality of analgesia. The relevance of the haemodynamic effects should be explored in larger validation studies.
authors.affiliation: Hospital Practitioner, CHU Clermont-Ferrand, Pôle Anesthésie-Réanimation-Estaing, Gynécologie-Obstétrique-Reproduction Humaine, Clermont-Ferrand, France.
authors.forename: M
authors.initials: M
authors.lastname: Bazin
authors.forename: M
authors.initials: M
authors.lastname: Bonnin
authors.forename: B
authors.initials: B
authors.lastname: Storme
authors.forename: F
authors.initials: F
authors.lastname: Bolandard
authors.forename: L
authors.initials: L
authors.lastname: Vernis
authors.forename: B
authors.initials: B
authors.lastname: Lavergne
authors.forename: B
authors.initials: B
authors.lastname: Pereira
authors.forename: J E
authors.initials: JE
authors.lastname: Bazin
authors.forename: C
authors.initials: C
authors.lastname: Dualé
mesh_terms: D000328:Adult; D015360:Analgesia, Epidural; D016362:Analgesia, Obstetrical; D016058:Analgesia, Patient-Controlled; D000701:Analgesics, Opioid / Q000008:administration & dosage*; D000779:Anesthetics, Local / Q000008:administration & dosage*; D002045:Bupivacaine / Q000008:administration & dosage / Q000031:analogs & derivatives; D003000:Clonidine / Q000008:administration & dosage*; D004311:Double-Blind Method; D005260:Female; D006439:Hemodynamics / Q000187:drug effects; D006801:Humans; D000077554:Levobupivacaine; D011247:Pregnancy; D017409:Sufentanil / Q000008:administration & dosage*
chemical_list: D000701:Analgesics, Opioid; D000779:Anesthetics, Local; D000077554:Levobupivacaine; D017409:Sufentanil; D003000:Clonidine; D002045:Bupivacaine