TITLE:
Comparison between 0.06% and 0.1% Levobupivacaine Combined with 2 μg/mL of Fentanyl for Epidural Labor Analgesia
AUTHORS:
Takako Hamada, Mariko Baba, Masaki Sato, Takayuki Saito, Keisuke Murakami, Hiroyuki Sumikura
KEYWORDS:
PCEA; CSEA; Labor Analgesia; Levobupivacaine
JOURNAL NAME:
Open Journal of Anesthesiology,
Vol.3 No.9,
November
21,
2013
ABSTRACT:
Purpose: Levobupivacaine is thought to be a good alternative to bupivacaine for epidural labor
analgesia because of its pharmacologic profile. However, the optimal
concentration of levobupivacaine for labor analgesia has not been adequately
studied. The objective of this retrospective study was to compare the analgesic
effect of levobupivacaine between 0.06% and 0.1% both combined with 2 μg/mL of
fentanyl. Methods: Primiparous women (ASA I, II) who delivered
their babies to our hospital using combined spinal
epidural analgesia and patient-controlled epidural analgesia between August 1,
2011 and September 30, 2011 were included into this retrospective study. The
analgesic solution for epidural administration was 0.06% levobupivacaine with 2
μg/mL of fentanyl between August 1 and 31, and 0.1% levobupivacaine with 2
μg/mL of fentanyl between
September 1 and 30. Their anesthetic and obstetric charts were reviewed to
compare obstetric outcome, anesthetic intervention, and patients’ satisfaction. Results: There
were 46 women fulfilling the inclusion criteria: 23 women in 0.06% group, and
23 women in 0.1% group. The number of patients who needed more than 3 requests
for one actual bolus was significantly higher in the 0.06% group (P 0.05). Conclusion: Our results revealed that 0.06%
levobupivacaine combined with 2 μg/mL fentanyl does not provide sufficient
analgesic effects for epidural labor analgesia. It seems that levobupivacaine
has not been adequately
studied after its withdrawal from the US market. Further studies should be conducted to determine the
optimal concentration of levobupivacaine for epidural labor analgesia.