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Dose-response study of spinal hyperbaric ropivacaine for cesarean section.
J Zhejiang Univ Sci B. 2006 Dec; 7(12):992-7.JZ

Abstract

BACKGROUND

Spinal hyperbaric ropivacaine may produce more predictable and reliable anesthesia than plain ropivacaine for cesarean section. The dose-response relation for spinal hyperbaric ropivacaine is undetermined. This double-blind, randomized, dose-response study determined the ED50 (50% effective dose) and ED95 (95% effective dose) of spinal hyperbaric ropivacaine for cesarean section anesthesia.

METHODS

Sixty parturients undergoing elective cesarean section delivery with use of combined spinal-epidural anesthesia were enrolled in this study. An epidural catheter was placed at the L1 approximately L2 vertebral interspace, then lumbar puncture was performed at the L3 approximately L4 vertebral interspace, and parturients were randomized to receive spinal hyperbaric ropivacaine in doses of 10.5 mg, 12 mg, 13.5 mg, or 15 mg in equal volumes of 3 ml. Sensory levels (pinprick) were assessed every 2.5 min until a T7 level was achieved and motor changes were assessed by modified Bromage Score. A dose was considered effective if an upper sensory level to pin prick of T7 or above was achieved and no intraoperative epidural supplement was required. ED50 and ED95 were determined with use of a logistic regression model.

RESULTS

ED50 (95% confidence interval) of spinal hyperbaric ropivacaine was determined to be 10.37 (5.23 approximately 11.59) mg and ED95 (95% confidence interval) to be 15.39 (13.81approximately 23.59) mg. The maximum sensory block levels and the duration of motor block and the rate of hypotension, but not onset of anesthesia, were significantly related to the ropivacaine dose.

CONCLUSION

The ED50 and ED95 of spinal hyperbaric ropivacaine for cesarean delivery under the conditions of this study were 10.37 mg and 15.39 mg, respectively. Ropivacaine is suitable for spinal anesthesia in cesarean delivery.

Authors+Show Affiliations

Department of Anesthesia, Women's Hospital, School of Medicine, Zhejiang University, Hangzhou 310006, China. chenxinz@zju.edu.cnNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Randomized Controlled Trial

Language

eng

PubMed ID

17111469

Citation

Chen, Xin-zhong, et al. "Dose-response Study of Spinal Hyperbaric Ropivacaine for Cesarean Section." Journal of Zhejiang University. Science. B, vol. 7, no. 12, 2006, pp. 992-7.
Chen XZ, Chen H, Lou AF, et al. Dose-response study of spinal hyperbaric ropivacaine for cesarean section. J Zhejiang Univ Sci B. 2006;7(12):992-7.
Chen, X. Z., Chen, H., Lou, A. F., & Lü, C. C. (2006). Dose-response study of spinal hyperbaric ropivacaine for cesarean section. Journal of Zhejiang University. Science. B, 7(12), 992-7.
Chen XZ, et al. Dose-response Study of Spinal Hyperbaric Ropivacaine for Cesarean Section. J Zhejiang Univ Sci B. 2006;7(12):992-7. PubMed PMID: 17111469.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Dose-response study of spinal hyperbaric ropivacaine for cesarean section. AU - Chen,Xin-zhong, AU - Chen,Hong, AU - Lou,Ai-fei, AU - Lü,Chang-cheng, PY - 2006/11/18/pubmed PY - 2007/1/5/medline PY - 2006/11/18/entrez SP - 992 EP - 7 JF - Journal of Zhejiang University. Science. B JO - J Zhejiang Univ Sci B VL - 7 IS - 12 N2 - BACKGROUND: Spinal hyperbaric ropivacaine may produce more predictable and reliable anesthesia than plain ropivacaine for cesarean section. The dose-response relation for spinal hyperbaric ropivacaine is undetermined. This double-blind, randomized, dose-response study determined the ED50 (50% effective dose) and ED95 (95% effective dose) of spinal hyperbaric ropivacaine for cesarean section anesthesia. METHODS: Sixty parturients undergoing elective cesarean section delivery with use of combined spinal-epidural anesthesia were enrolled in this study. An epidural catheter was placed at the L1 approximately L2 vertebral interspace, then lumbar puncture was performed at the L3 approximately L4 vertebral interspace, and parturients were randomized to receive spinal hyperbaric ropivacaine in doses of 10.5 mg, 12 mg, 13.5 mg, or 15 mg in equal volumes of 3 ml. Sensory levels (pinprick) were assessed every 2.5 min until a T7 level was achieved and motor changes were assessed by modified Bromage Score. A dose was considered effective if an upper sensory level to pin prick of T7 or above was achieved and no intraoperative epidural supplement was required. ED50 and ED95 were determined with use of a logistic regression model. RESULTS: ED50 (95% confidence interval) of spinal hyperbaric ropivacaine was determined to be 10.37 (5.23 approximately 11.59) mg and ED95 (95% confidence interval) to be 15.39 (13.81approximately 23.59) mg. The maximum sensory block levels and the duration of motor block and the rate of hypotension, but not onset of anesthesia, were significantly related to the ropivacaine dose. CONCLUSION: The ED50 and ED95 of spinal hyperbaric ropivacaine for cesarean delivery under the conditions of this study were 10.37 mg and 15.39 mg, respectively. Ropivacaine is suitable for spinal anesthesia in cesarean delivery. SN - 1673-1581 UR - https://www.unboundmedicine.com/medline/citation/17111469/Dose_response_study_of_spinal_hyperbaric_ropivacaine_for_cesarean_section_ DB - PRIME DP - Unbound Medicine ER -