Tags

Type your tag names separated by a space and hit enter

Epidural block with ropivacaine and bupivacaine for elective caesarean section: maternal cardiovascular parameters, comfort and neonatal well-being.
Curr Med Res Opin. 2004 Jan; 20(1):7-12.CM

Abstract

OBJECTIVE

To determine cardiovascular effects and neonatal outcome of ropivacaine 0.75% and bupivacaine 0.5% for elective epidural caesarean section.

RESEARCH DESIGN AND METHODS

Healthy pregnant women, scheduled for elective caesarean section, were enrolled in this randomised, double-blind study. Epidural block was obtained with 20-30 ml of ropivacaine 0.75% (Group R) or bupivacaine 0.5% (Group B) and surgery did not commence until anaesthesia was achieved bilaterally to T6.

MAIN OUTCOME MEASURES

Maternal heart rate and blood pressure were assessed before the main dose of local anaesthetic and at 5-min intervals until 35 min. Neonatal umbilical pH and Apgar scores were determined after delivery. Ten, twenty and thirty minutes after the main dose, sensory and motor block characteristics were determined. Quality of analgesia was assessed by the anaesthetist, surgeon and the patient. Adverse events were recorded.

RESULTS

Sixty-two patients were enrolled and the data of 60 of them were eligible for analysis: 31 in Group R and 29 in Group B. The area under the curve (AUC) for maternal heart rate decreased significantly less in Group B than in Group R (p = 0.038). Twenty-five and thirty minutes after administration of the main local anaesthetic dose, heart rate decreased significantly less in Group B than in Group R (p = 0.006 and p = 0.007). There was no difference in AUC for maternal blood pressure (p = 0.32). Repeated measurement analysis showed no difference between groups in motor block (p = 0.78) and in spread of the sensory block (lower level: p = 0.83, upper level: p = 0.88). There was no statistical difference in neonatal umbilical pH (p = 0.22) and Apgar score (p = 0.59). Multiple linear regression analysis showed a significant influence of maternal body mass index on neonatal pH (p = 0.004), but not of maternal blood pressure (p = 0.323), nor of maternal heart rate (p = 0.12). The quality of analgesia and incidence of adverse events were similar in both groups.

CONCLUSIONS

Both drugs produced equally satisfactory epidural block. Although ropivacaine 0.75% resulted in a greater decrease of maternal heart rate, this effect did not influence neonatal well-being. Both ropivacaine 0.75% and bupivacaine 0.5% can therefore be recommended for epidural anaesthesia in elective caesarean section.

Authors+Show Affiliations

Department of Anaesthesiology, University of Cologne, Joseph-Stelzmann-Strasse 9, 50931 Cologne, Germany. Sandra.Kampe@medizin.uni-koeln.deNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Clinical Trial
Comparative Study
Journal Article
Randomized Controlled Trial
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

14741065

Citation

Kampe, Sandra, et al. "Epidural Block With Ropivacaine and Bupivacaine for Elective Caesarean Section: Maternal Cardiovascular Parameters, Comfort and Neonatal Well-being." Current Medical Research and Opinion, vol. 20, no. 1, 2004, pp. 7-12.
Kampe S, Tausch B, Paul M, et al. Epidural block with ropivacaine and bupivacaine for elective caesarean section: maternal cardiovascular parameters, comfort and neonatal well-being. Curr Med Res Opin. 2004;20(1):7-12.
Kampe, S., Tausch, B., Paul, M., Kasper, S. M., Bauer, K., Diefenbach, C., & Kiencke, P. (2004). Epidural block with ropivacaine and bupivacaine for elective caesarean section: maternal cardiovascular parameters, comfort and neonatal well-being. Current Medical Research and Opinion, 20(1), 7-12.
Kampe S, et al. Epidural Block With Ropivacaine and Bupivacaine for Elective Caesarean Section: Maternal Cardiovascular Parameters, Comfort and Neonatal Well-being. Curr Med Res Opin. 2004;20(1):7-12. PubMed PMID: 14741065.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Epidural block with ropivacaine and bupivacaine for elective caesarean section: maternal cardiovascular parameters, comfort and neonatal well-being. AU - Kampe,Sandra, AU - Tausch,Brigitte, AU - Paul,Matthias, AU - Kasper,Stefan-Mario, AU - Bauer,Klaus, AU - Diefenbach,Christoph, AU - Kiencke,Peter, PY - 2004/1/27/pubmed PY - 2004/4/22/medline PY - 2004/1/27/entrez SP - 7 EP - 12 JF - Current medical research and opinion JO - Curr Med Res Opin VL - 20 IS - 1 N2 - OBJECTIVE: To determine cardiovascular effects and neonatal outcome of ropivacaine 0.75% and bupivacaine 0.5% for elective epidural caesarean section. RESEARCH DESIGN AND METHODS: Healthy pregnant women, scheduled for elective caesarean section, were enrolled in this randomised, double-blind study. Epidural block was obtained with 20-30 ml of ropivacaine 0.75% (Group R) or bupivacaine 0.5% (Group B) and surgery did not commence until anaesthesia was achieved bilaterally to T6. MAIN OUTCOME MEASURES: Maternal heart rate and blood pressure were assessed before the main dose of local anaesthetic and at 5-min intervals until 35 min. Neonatal umbilical pH and Apgar scores were determined after delivery. Ten, twenty and thirty minutes after the main dose, sensory and motor block characteristics were determined. Quality of analgesia was assessed by the anaesthetist, surgeon and the patient. Adverse events were recorded. RESULTS: Sixty-two patients were enrolled and the data of 60 of them were eligible for analysis: 31 in Group R and 29 in Group B. The area under the curve (AUC) for maternal heart rate decreased significantly less in Group B than in Group R (p = 0.038). Twenty-five and thirty minutes after administration of the main local anaesthetic dose, heart rate decreased significantly less in Group B than in Group R (p = 0.006 and p = 0.007). There was no difference in AUC for maternal blood pressure (p = 0.32). Repeated measurement analysis showed no difference between groups in motor block (p = 0.78) and in spread of the sensory block (lower level: p = 0.83, upper level: p = 0.88). There was no statistical difference in neonatal umbilical pH (p = 0.22) and Apgar score (p = 0.59). Multiple linear regression analysis showed a significant influence of maternal body mass index on neonatal pH (p = 0.004), but not of maternal blood pressure (p = 0.323), nor of maternal heart rate (p = 0.12). The quality of analgesia and incidence of adverse events were similar in both groups. CONCLUSIONS: Both drugs produced equally satisfactory epidural block. Although ropivacaine 0.75% resulted in a greater decrease of maternal heart rate, this effect did not influence neonatal well-being. Both ropivacaine 0.75% and bupivacaine 0.5% can therefore be recommended for epidural anaesthesia in elective caesarean section. SN - 0300-7995 UR - https://www.unboundmedicine.com/medline/citation/14741065/Epidural_block_with_ropivacaine_and_bupivacaine_for_elective_caesarean_section:_maternal_cardiovascular_parameters_comfort_and_neonatal_well_being_ L2 - https://www.tandfonline.com/doi/full/10.1185/030079903125002649 DB - PRIME DP - Unbound Medicine ER -