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> 0.125% ropivacaine is similar to 0.125% bupivacaine for labor analgesia using patient-controlled epidural infusion
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Owen MD, D'Angelo R, Gerancher JR, Thompson JM, Foss ML, Babb JD, Eisenach JC. > 0.125% ropivacaine is similar to 0.125% bupivacaine for labor analgesia using patient-controlled epidural infusion. Anesth Analg 1998; 86:527-531. This interesting study demonstrates the possibility of using lower doses, thus minimizing the side effects of either ropivacaine or bupivacaine with patient-controlled epidural analgesia. However, a potential benefit of ropivacaine was not demonstrated.
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Irestedt L, Ekblom A, Olofsson C, Dahlstrom AC, Emanuelsson BM. Pharmacokinetics and clinical effect during continuous epidural infusion with rupivacaine 2.5 mg/ml or bupivacaine 2.5 mg/ml for labour pain relief. Acta Anesthesiol Scand 1998; 42:890-896.
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Da Conceicao MJ, Coelho L. Caudal anaesthesia with 0.375% ropivacaine or 0.375% bupivacaine in paediatric patients. Br J Anaesth 1998; 80:507-508. In this study, the higher caudal ropivacaine concentration still demonstrates less intense and shorter duration of motor blockade compared to bupivacaine, a credit for the drug in this indication.
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Brodner G, Mertes N, Van Aken H, Pogatzki E, Buerkle H, Marcus MA, Mollhoff T. Epidural analgesia with local anesthetics after abdominal surgery: earlier motor recovery with 0.2% ropivacaine than 0.175% bupivacaine. Anesth Analg 1999; 88:128-133. This first study of ropivacaine with an opioid demonstrates a benefit of ropivacaine with regard to motor blockade - however, the chosen bupivacaine concentration is unusually high for this indication and a relatively large amount of sufentanil might have contributed to the comparable quality of analgesia.
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Polley LS, Columb MO, Naughton NN, Wagner DS, van de Ven CJ. Relative analgesic potencies of ropivacaine and bupivacaine for epidural analgesia in labor: implications for therapeutic indexes. Anesthesiology 1999; 90:944-950. Using the MLAC technique, this study found a potency ratio of 0.6 for ropivacaine versus bupivacaine for epidural analgesia in labor.
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Capogna G, Celleno D, Fusco P, Lyons G, Columb M. Relative potencies of bupivacaine and ropivacaine for analgesia in labour. Br J Anaesth 1999; 82:371-373. Similar study design with identical results to reference 13.
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Cox CR, Faccenda KA, Gilhooly C, Bannister J, Scott NB, Morrison LMM. Extradural S-(-)-bupivacaine: Comparison with racemic RS-bupivacaine. Br J Anaesth 1998; 80:289-293. Direct comparison revealed similar properties of both local anaesthetics.
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Lyons, G.1
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