Why the study?
Does highly dilute epidural bupivacaine (0.031% or 0.062%) provide equivalent analgesia to 0.125% bupivacaine in primigravid mothers in labour?
Does highly dilute epidural bupivacaine (0.031% or 0.062%) provide equivalent analgesia to 0.125% bupivacaine in primigravid mothers in labour?
Using very dilute bupivacaine (0.031%) for epidural infusion during labour provides inferior analgesia in the first 4 hours without obvious benefit.
Avoid 0.031% bupivacaine epidural infusions in labour; confirms non-equivalence of ultra-dilute solutions to standard concentrations.
We have compared the effects of three epidural infusions in a randomised, double-blind study of 56 primigravid mothers in labour. An initial dose of bupivacaine 0.5% 8 ml was followed by infusion of either bupivacaine 0.125%, 0.062% or 0.031%. All solutions contained fentanyl 0.0002% and were run at 7.5 ml/hour. Women receiving the most dilute solution had significantly less analgesia (p less than 0.001) for the first 4 hours of the study, but pain scores were then similar for the three groups. No obvious benefit was gained by using very dilute bupivacaine.
No takes yet. Share an insight, caveat, or question.
Noble et al. (1991) studied this question.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: