International Journal of Obstetric Anesthesia
Volume 17, Issue 4 , Pages 315-321 , October 2008

Impact of the addition of sufentanil 5 μg or clonidine 75 μg on the minimum local analgesic concentration of ropivacaine for epidural analgesia in labour: a randomized comparison

  • P.Y. Dewandre

      Affiliations

    • Department of Anesthesia and Intensive Care Medicine, CHR de la Citadelle, Liege University Hospital, Liege, Belgium
    • Corresponding Author InformationCorrespondence to: P.Y. Dewandre, Department of Anesthesia and Intensive Care Medicine, CHR de la Citadelle, 1 Boulevard du 12eme de Ligne, 4000 Liege, Belgium. Tel.: +32 4 225 71 51.
    • ,
  • M. Kirsch

      Affiliations

    • Department of Anesthesia and Intensive Care Medicine, CHR de la Citadelle, Liege University Hospital, Liege, Belgium
    • ,
  • V. Bonhomme

      Affiliations

    • Department of Anesthesia and Intensive Care Medicine, CHR de la Citadelle, Liege University Hospital, Liege, Belgium
    • ,
  • M. Columb

      Affiliations

    • Acute Intensive Care, University Hospital of South Manchester, Wythenshawe, UK
    • ,
  • P. Hans

      Affiliations

    • Department of Anesthesia and Intensive Care Medicine, CHR de la Citadelle, Liege University Hospital, Liege, Belgium
    • ,
  • J.F. Brichant

      Affiliations

    • Department of Anesthesia and Intensive Care Medicine, CHR de la Citadelle, Liege University Hospital, Liege, Belgium

,Accepted 24 May 2008.

References 

  1. Olofsson C, Ekblom A, Ekman-Ordeberg G, Irestedt L. Obstetric outcome following epidural analgesia with bupivacaine-adrenaline 0.25% or bupivacaine 0.125% with sufentanil: a prospective randomized controlled study in 1000 parturients. Acta Anaesthesiol Scand. 1998;42:284–292
  2. Murphy JD, Henderson K, Bowden MI, Lewis M, Cooper GM. Bupivacaine versus bupivacaine plus fentanyl for epidural analgesia: effect on maternal satisfaction. BMJ. 1991;302:564–567
  3. Chestnut DH, Owen CL, Bates JN, Ostman LG, Choi WW, Geiger MW. Continuous infusion epidural analgesia during labor: a randomized, double-blinded comparison of 0.0625% bupivacaine/ 0.0002% fentanyl versus 0.125% bupivacaine. Anesthesiology. 1988;68:754–759
  4. Vertommen JD, Vandermeulen E, Van Aken H, et al. The effects of the addition of sufentanil to 0.125% bupivacaine on the quality of analgesia during labor and on the incidence of instrumental deliveries. Anesthesiology. 1991;74:809–814
  5. Comparative obstetric mobile epidural trial (COMET) Study Group UK. Randomized controlled trial comparing traditional with two “mobile” epidural techniques. Anesthetic and Analgesic Efficacy. Anesthesiology 2002; 97: 1567–75.
  6. Comparative obstetric mobile epidural trial (COMET) Study Group UK. Effect of low-dose mobile versus traditional epidural techniques on mode of delivery: a randomised controlled trial. Lancet 2001, 358: 19–23.
  7. Landau R, Schiffer E, Morales M, Savoldelli G, Kern C. The dose-sparing effect of clonidine added to ropivacaine for labor epidural analgesia. Anesth Analg. 2002;95:728–734
  8. Gogarten W, Van de Velde M, Soetens F, et al. A multicenter trial comparing different concentrations of ropivacaine plus sufentanil with bupivacaine plus sufentanil for patient-controlled epidural analgesia in labour. Eur J Anaesthesiol. 2004;21:38–45
  9. Burnstein R, Buckland R, Pickett JA. A survey of epidural analgesia for labour in the United Kingdom. Anaesthesia. 1999;54:634–640
  10. O’Meara ME, Gin T. Comparison of 0.125% bupivacaine with 0.125% bupivacaine and clonidine as extradural analgesia in the first stage of labour. Br J Anaesth. 1993;71:651–656
  11. Cigarini I, Kaba A, Bonnet F, et al. Epidural clonidine combined with bupivacaine for analgesia in labor. Effects on mother and neonate. Reg Anesth. 1995;20:113–120
  12. Chassard D, Mathon L, Dailler F, Golfier F, Tournade JP, Bouletreau P. Extradural clonidine combined with sufentanil and 0.0625% bupivacaine for analgesia in labour. Br J Anaesth. 1996;77:458–462
  13. Eisenach JC, De Kock M, Kimscha W. Alpha sub 2-adrenergic agonists for regional anaesthesia: a clinical review of clonidine (1984–1995). Anesthesiology. 1996;85:655–674
  14. Tremlett MR, Kelly PJ, Parkins J, Hughes D, Redfern N. Low-dose clonidine infusion during labour. Br J Anaesth. 1999;83:257–261
  15. Aveline C, El Metaoua S, Masmoudi A, Boelle PY, Bonet F. The effect of clonidine on the minimum local analgesic concentration of epidural ropivacaine during labor. Anesth Analg. 2002;95:735–740
  16. D’Angelo R. Should we administer epidural or spinal clonidine during labor?. Reg Anesth Pain Med. 2000;25:3–4
  17. Lyons G, Columb M, Hawthorne L, Dresner M. Extradural pain relief in labour: bupivacaine sparing by extradural fentanyl is dose dependent. Br J Anaesth. 1997;78:493–497
  18. Polley LS, Columb MO, Wagner DS, Naughton NN. Dose-dependent reduction of the minimum local analgesic concentration of bupivacaine by sufentanil for epidural analgesia in labor. Anesthesiology. 1998;89:626–632
  19. Phillips G. Continuous infusion epidural analgesia in labor: the effect of adding sufentanil to 0.125% bupivacaine. Anesth Analg. 1988;67:462–465
  20. Vertommen JD, Lemmens E, Van Aken H. Comparison of the addition of three different doses of sufentanil to 0.125% bupivacaine given epidurally during labour. Anaesthesia. 1994;49:678–681
  21. Columb MO, Lyons G. Determination of the minimum local analgesic concentrations of epidural bupivacaine and lidocaine in labor. Anesth Analg. 1995;81:833–837
  22. Capogna G, Celleno D, Fusco P, Lyons G, Columb M. Relative potencies of bupivacaine and ropivacaine for analgesia in labour. Br J Anaesth. 1999;82:371–373
  23. Palm S, Gertzen W, Ledowski T, Gleim M, Wulf H. Minimum local analgesic dose of plain ropivacaine vs ropivacaine combined with sufentanil during epidural analgesia for labour. Anaesthesia. 2001;56:526–529
  24. Polley LS, Columb MO, Naughton NN, Wagner DS, van de Ven CJ. Effect of epidural epinephrine on the minimum local analgesic concentration of epidural bupivacaine in labor. Anesthesiology. 2002;96:1123–1128
  25. Polley LS, Columb MO, Naughton NN, Wagner DS, van de Ven CJM, Goralski KH. Relative analgesic potencies of levobupivacaine and ropivacaine for epidural analgesia in labor. Anesthesiology. 2003;99:1354–1358
  26. Buyse I, Stockman W, Columb M, Vandermeersch E, Van de Velde M. Effect of sufentanil on minimum local analgesic concentrations of epidural bupivacaine, ropivacaine and levobupivacaine in nullipara in early labour. Int J Obstet Anesth. 2007;16:22–28
  27. Dixon WJ, Massey FJ. Introduction to statistical analysis. 4th ed.. New York: McGraw-Hill; 1983;
  28. Lee BB, Ngan Kee WD, Wong EL, Liu JY. Dose-response study of epidural ropivacaine for labor analgesia. Anesthesiology. 2001;94:767–772
  29. Van Steenberge A, Debroux HC, Noorduin H. Extradural bupivacaine with sufentanil for vaginal delivery. A double-blind trial. Br J Anaesth. 1987;59:1518–1522
  30. Ledin Eriksson S, Frykholm P, Stenlund PM, Olofsson C. A comparison of three doses of sufentanil in combination with bupivacaine-adrenaline in continuous epidural analgesia during labour. Acta Anaesthesiol Scand. 2000;44:919–923
  31. Debon R, Allaouchiche B, Duflo F, Boselli E, Chassard D. The analgesic effects of sufentanil combined with ropivacaine 0.2% for labor analgesia: a comparison of three sufentanil doses. Anesth Analg. 2001;92:180–183
  32. Graft BM, Zauzig Y, Zink W. Current status and clinical relevance of studies of minimum local-anaesthetic concentration (MLAC). Curr Opin Anesthesiol. 2005;18:241–245
  33. Benhamou D, Mercier FJ, Ben Ayed M, Auroy Y. Continuous epidural analgesia with bupivacaine 0.125% or bupivacaine 0.0625% plus sufentanil 0.25 μg/ml: a study in singleton breech presentation. Int J Obstet Anesth. 2002;11:13–18
  34. Panni MK, Segal S. Local anesthetic requirements are greater in dystocia than in normal labor. Anesthesiology. 2003;98:957–963
  35. Capogna G, Celleno D, Lyons G, Columb M, Fusco P. Minimum local analgesic concentration of extradural bupivacaine increases with progression of labour. Br J Anaesth. 1998;80:11–13
  36. Panni MK, Columb MO. Obese parturients have lower epidural local anaesthetic requirements for analgesia in labour. Br J Anaesth. 2006;96:106–110
  37. Capogna G, Parpaglioni R, Lyons G, Columb M, Celleno D. Minimum analgesic dose of epidural sufentanil for first-stage labor analgesia: a comparison between spontaneous and prostaglandin–induced labors in nulliparous women. Anesthesiology. 2001;94:740–744
  38. Melzack R. Labour is still painful after prepared childbirth training. Can Med Assoc J. 1981;125:357–363
  39. Lowe NK. The nature of labor pain. Am J Obstet Gynecol. 2002;186:S16–S24
  40. Olayemi O, Adeniji RA, Udoh Es, Aimakhu CO, Shoretire KA. Determinants of pain perception in labour among parturients at the university college hospital, Ibadan. J Obstet Gynaecol. 2005;25:128–130
  41. Polley L, Columb M, Naughton N, Wagner D. Comparison of the minimum local analgesic concentration of bupivacaine for nulliparous and multiparous women in labor. Anesthesiology 2002; 96(Suppl 1): P-54.
  42. Rafati J, Bonhomme V, Dewandre PY, Hans P, Brichant JF. The minimum local analgesic concentration of ropivacaine in the first stage of labor is similar in primiparas and multiparas. Anesthesiology. 2004;101:A1215
  43. Polley L, Columb M, Naughton N, Wagner D, van de Ven C. Relative analgesic potencies of ropivacaine and bupivacaine for epidural analgesia in labor: implications for therapeutic indexes. Anesthesiology. 1999;90:944–950

PII: S0959-289X(08)00094-0

doi: 10.1016/j.ijoa.2008.05.005

International Journal of Obstetric Anesthesia
Volume 17, Issue 4 , Pages 315-321 , October 2008

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