Why the study?
Does a 0.08% solution of bupivacaine improve intervention-free intervals compared to a 0.25% solution in mothers in labour receiving continuous epidural analgesia?
Does a 0.08% solution of bupivacaine improve intervention-free intervals compared to a 0.25% solution in mothers in labour receiving continuous epidural analgesia?
Administration of a larger volume, lower concentration (0.08%) solution of bupivacaine by continuous epidural pump infusion is more labour-saving and requires fewer interventions than a smaller volume, higher concentration (0.25%) solution at the same total dose.
Answers are grounded in this paper and cite their sources.
0.08% bupivacaine extends intervention-free intervals and reduces top-ups in labor epidurals; supports low-concentration regimens to lessen clinician workload.
The effects of 0.08% (Group A) and 0.25% (Group B) solutions of bupivacaine were compared in a random manner, to assess continuous pump infusion epidural analgesia in labour. Both solutions were infused at a dose rate of 20 mg bupivacaine/hour. The results in all the mothers who had received infusions lasting more than 4 hours were studied. There were 25 in Group A and 28 in Group B. Any treatment during the infusion epidural for inadequate analgesia, hypotension, etc., was recorded as an intervention. The mean of the intervention-free intervals was significantly greater in Group A than in Group B, and significantly fewer top-up injections were required in Group A. The results show that the administration of a 0.08% solution of bupivacaine into the epidural space by continuous pump infusion is more labour saving than the infusion of a 0.25% solution. The concept that a greater volume infusion rate maintains a more extended liquid sleeve of local anaesthetic in the epidural space is supported.
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Ewen et al. (1986) studied this question.
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