摘要
Abstract
Objective To compare the epidural analgesic potencies of bupivacaine, levobupivacaine and ropivacaine in patient-control ed labor analgesia. Methods Four hundred and fifty term nul iparous women were randomly assigned to re-ceive patient-control ed epidural labor analgesia with bupivacaine, levobupivacaine or ropivacaine combined with 0.5μg/ml sufentanil (n=150 in each group), and each group were divided into 5 subgroups with concentrations of 0.050%, 0.075%, 0.100%, 0.125% and 0.150%, respectively (n=30 in each subgroup). The initial bolus of the anesthetic solution was 8 ml, fol-lowed by continuous background infusion of 5 ml/h, bolus dose of 5 ml and a lockout of 15 min. The results of analgesia and obstetrics were recorded. Results No demographic and obstetric data differences were found among three groups(P>0.05). The 50% and 95% effective concentrations for epidural labor analgesia were 0.043% and 0.198% (bupivacaine), 0.055% and 0.254%(levobupivacaine), 0.058%and 0.269%(ropivacaine), respectively. The relative median potencies (95% CI) of three lo-cal anesthetics were bupivacaine/levobupivacaine: 0.7808 (0.4601~1.1655), bupivacaine/ropivacaine: 0.7378(0.4241~1.0980), and levobupivacaine/ropivacaine: 0.9449 (0.6064~1.4251). Logistic regression analysis showed that the analgesic effect was significantly related to the concentration of local anesthetics (OR=1.451, P<0.05), with a poor relation to the type of local anesthetic(OR=0.576, P>0.05). Conclusion The relative analgesic potencies of bupivacaine, levobupivacaine and ropivacaine are similar under epidural labor analgesia at low concentration. The analgesic effect mainly depends on the concentration of lo-cal anesthetics.关键词
布比卡因/左旋布比卡因/罗哌卡因/镇痛/产科/硬膜外Key words
Bupivacaine/Levobupivacaine/Ropivacaine/Analgesia/Obstetrical/Epidural
