Minimum local analgesic concentration of extradural bupivacaine increases with progression of labour.

Abstract:

:We have used the technique of double-blind sequential allocation to quantify the minimum local analgesic concentration (MLAC) of extradural bupivacaine for women in early (median cervical dilatation 2 cm) and late (median cervical dilatation 5 cm) labour. The first bolus was 20 ml of the bupivacaine test solution. The concentration was determined by the response of the previous woman to a higher or lower concentration of bupivacaine according to up and down sequential allocation. Efficacy was assessed using a 100-mm visual analogue pain score (VAPS). The test solution had to achieve a VAPS of 10 mm or less to be judged effective. In early labour, the MLAC of bupivacaine was 0.048% w/v (95% confidence intervals (CI) 0.037-0.058% w/v), and 0.140% w/v (95% CI 0.132-0.150% w/v) in the late group. The MLAC of bupivacaine in late labour was greater by a factor of 2.9 (95% CI 2.7-3.2) compared with the MLAC in early labour (P < 0.0001, 95% CI difference 0.08-0.11). We conclude that advancing labour requires an increased concentration of extradural bupivacaine for pain relief.

journal_name

Br J Anaesth

authors

Capogna G,Celleno D,Lyons G,Columb M,Fusco P

doi

10.1093/bja/80.1.11

subject

Has Abstract

pub_date

1998-01-01 00:00:00

pages

11-3

issue

1

eissn

0007-0912

issn

1471-6771

pii

S0007-0912(17)40572-1

journal_volume

80

pub_type

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