International journal of obstetric anesthesia
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Int J Obstet Anesth · Jul 2009
Randomized Controlled TrialEffects of epidural clonidine and neostigmine following intrathecal labour analgesia: a randomised, double-blind, placebo-controlled trial.
The limited duration of spinal labour analgesia combined with problems associated with maintenance of epidural analgesia, have prompted the search for combinations that could prolong spinal analgesia. A randomised, double-blind trial was carried out to test the hypotheses (a) that initial spinal labour analgesia is prolonged by administering clonidine and neostigmine epidurally whilst (b) the hourly local anaesthetic consumption is reduced. ⋯ Epidural administration of neostigmine 500 microg and clonidine 75 microg, following the intrathecal injection of ropivacaine and sufentanil, prolongs analgesia and reduces hourly ropivacaine consumption.
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Int J Obstet Anesth · Jul 2009
Randomized Controlled Trial Comparative StudyMinimum local analgesic concentrations of ropivacaine and levobupivacaine with sufentanil for epidural analgesia in labour.
Sufentanil is often added to ropivacaine and levobupivacaine to provide epidural analgesia in labour. The aim of this study was to compare the analgesic potencies of epidural ropivacaine and levobupivacaine in combination with sufentanil 0.5 microg/mL, using the minimum local analgesic concentration (MLAC) model with up-down sequential allocation. ⋯ When sufentanil 0.5 microg/mL was added to either ropivacaine or levobupivacaine for labour analgesia, no significant difference in analgesic potency was observed.
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Int J Obstet Anesth · Jul 2009
Randomized Controlled Trial Comparative StudySingle-shot spinal anaesthesia, combined spinal-epidural and epidural volume extension for elective caesarean section: a randomized comparison.
Single-shot spinal and combined spinal-epidural block, with or without epidural volume extension, can be used for caesarean section. There is no trial comparing their block characteristics and adverse effects under identical conditions. ⋯ Intrathecal block is similar in extent and duration whether given as a single-shot spinal or a combined spinal-epidural with or without epidural volume extension when performed for elective caesarean section using hyperbaric bupivacaine in the sitting position.