What question did this study set out to answer?

To evaluate whether lowering the bupivacaine concentration to 0.125% decreases the total drug dose required without compromising the analgesic effectiveness of an obstetric epidural block.

January 1, 1978AnaesthesiaOpen Access

0·125% bupivacaine for obstetric analgesia?

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Why the study?

Does 0.125% bupivacaine reduce the total dose of drug given without reducing the efficiency of epidural block compared to 0.25% and 0.375% bupivacaine in primiparous patients at term?

Population

93 fit primiparous patients at term with singleton pregnancies and vertex presentation. Excluded…

Comparison

0.125% bupivacaine for obstetric epidural… vs 0.25% and 0.375% bupivacaine

Design

RCT, randomly allocated to one of the three concentrations

Authors

SSSHELAGH F. STAINTHORPUniversity of Manchester EBE. G. BRADSHAWManchester University NHS Foundation Trust PCPeter ChallenWestminster Cathedral

Discussion

Member takes

Implication

0.125% bupivacaine raises epidural failure risk in labor; challenges ultra-low concentration use despite lower dose when effective.

Key Points

To evaluate whether lowering the bupivacaine concentration to 0.125% decreases the total drug dose required without compromising the analgesic effectiveness of an obstetric epidural block.
Prospective randomized trial involving 93 healthy primiparous patients at term with singleton pregnancies in vertex presentation, excluding those with intercurrent medical disease or toxaemia.
Patients were randomly allocated to receive one of three bupivacaine concentrations for epidural analgesia: 0.125%, 0.25%, or 0.375%.
The 0.125% bupivacaine concentration resulted in a significantly higher failure rate of analgesia compared to both the 0.25% and 0.375% concentrations.
In the subgroup of patients where 0.125% bupivacaine successfully achieved complete pain relief, there was a significant reduction in the total amount of drug consumed.

Structured PICO

Does 0.125% bupivacaine reduce the total dose of drug given without reducing the efficiency of epidural block compared to 0.25% and 0.375% bupivacaine in primiparous patients at term?

Population

93 fit primiparous patients at term with singleton pregnancies and vertex presentation. Excluded: intercurrent medical disease or toxaemia.

Intervention

0.125% bupivacaine for obstetric epidural analgesia

Comparator

0.25% and 0.375% bupivacaine

Outcome

Effectiveness of epidural block (failure rate) and total dose of drug givenpatient reported

While 0.125% bupivacaine reduces the total drug dose when effective, it is associated with a significantly higher failure rate for obstetric epidural analgesia compared to higher concentrations.

Cite This Study

STAINTHORP et al. (1978) studied this question.

synapsesocial.com/papers/6a83271dff6798fd267d6541 https://doi.org/10.1111/j.1365-2044.1978.tb08269.x

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0·125% bupivacaine for obstetric analgesia?

Discussion

Member takes

Implication

Key Points

Structured PICO

Cite This Study

0·125% bupivacaine for obstetric analgesia?

Discussion

Member takes

Implication

Key Points

Structured PICO

Cite This Study

Also Consider

Also Consider