Effects of Local Anesthetic on the Time Between Analgesic Boluses and the Duration of Labor in Patient-Controlled Epidural Analgesia: Prospective Study of Two Ultra-Low Dose Regimens of Ropivacaine and Sufentanil

Authors

  • José Manuel Costa-Martins Departamento de Anestesiologia. Maternidade Alfredo da Costa. Lisboa. Portugal.
  • Cláudia Camila Dias Departamento de Ciências da Informação e da Decisão em Saúde. Faculdade de Medicina. Universidade do Porto. Porto. Portugal.
  • Marco Pereira Faculdade de Psicologia e de Ciências da Educação. Universidade de Coimbra. Coimbra. Portugal.
  • Jorge Tavares Departamento de Anestesiologia. Hospital de São João. Faculdade de Medicina. Universidade do Porto. Porto. Portugal.

DOI:

https://doi.org/10.20344/amp.5708

Abstract

Background: Patient-controlled epidural analgesia with low concentrations of anesthetics is effective in reducing labor pain. The aim of this study was to assess and compare two ultra-low dose regimens of ropivacaine and sufentanil (0.1% ropivacaine plus 0.5 μg.ml-1 sufentanil vs. 0.06% ropivacaine plus 0.5 μg.ml-1 sufentanil) on the intervals between boluses and the duration of labor.
Material and Methods: In this non-randomized prospective study, conducted between January and July 2010, two groups of parturients received patient-controlled epidural analgesia: Group I (n = 58; 1 mg.ml-1 ropivacaine + 0.5 μg.ml-1 sufentanil) and Group II (n = 57; 0.6 mg.ml-1 ropivacaine + 0.5 μg.ml-1 sufentanil). Rescue doses of ropivacaine at the concentration of the assigned group without sufentanil were administered as necessary. Pain, local anesthetic requirements, neuraxial blockade characteristics, labor and neonatal outcomes, and maternal satisfaction were recorded.
Results: The ropivacaine dose was greater in Group I (9.5 [7.7-12.7] mg.h-1 vs. 6.1 [5.1-9.8 mg.h-1], p < 0.001). A time increase between each bolus was observed in Group I (beta = 32.61 min, 95% CI [25.39; 39.82], p < 0.001), whereas a time decrease was observed in Group II (beta = -1.40 min, 95% CI [-2.44; -0.36], p = 0.009). The duration of the second stage of labor in Group I was significantly longer
than that in Group II (78 min vs. 65 min, p < 0.001).
Conclusions: Parturients receiving 0.06% ropivacaine exhibited less evidence of cumulative effects and exhibited faster second stage progression than those who received 0.1% ropivacaine.
Keywords: Analgesia, Obstetrical; Analgesia, Patient-Controlled; Labor Pain; Ropivacaine; Sufentanil.

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Published

2015-02-27

How to Cite

1.
Costa-Martins JM, Dias CC, Pereira M, Tavares J. Effects of Local Anesthetic on the Time Between Analgesic Boluses and the Duration of Labor in Patient-Controlled Epidural Analgesia: Prospective Study of Two Ultra-Low Dose Regimens of Ropivacaine and Sufentanil. Acta Med Port [Internet]. 2015 Feb. 27 [cited 2024 Mar. 29];28(1):70-6. Available from: https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/5708