Purdie N L, McGrady E M
University Department of Anaesthesia, Glasgow Royal Infirmary, Alexandra Parade, Glasgow, G31 2ER, UK.
Anaesthesia. 2004 Feb;59(2):133-7. doi: 10.1111/j.1365-2044.2004.03582.x.
The aim of the study was to compare the relative potencies and clinical characteristics of epidural ropivacaine and levobupivacaine in labour using patient-controlled epidural analgesia (PCEA). In a randomised double-blinded study, 60 ASA I or II primigravidae requesting epidural analgesia in early labour were allocated to receive either 0.1% ropivacaine with fentanyl 0.0002% or 0.1% levobupivacaine with 0.0002% fentanyl via a patient-controlled analgesia pump. Analgesia was established with 15 ml of study solution and maintained using 5-ml boluses of study solution with a 5-min lockout interval. There were no significant differences in onset time, duration and quality of analgesia, motor and sensory blockade, local anaesthetic consumption, mode of delivery, neonatal outcome or maternal satisfaction between the groups. We conclude that 0.1% ropivacaine with 0.0002% fentanyl and 0.1% levobupivacaine with 0.0002% fentanyl are clinically indistinguishable for labour analgesia and appear pharmacologically equipotent when using PCEA.
本研究的目的是使用患者自控硬膜外镇痛（PCEA）比较罗哌卡因和左旋布比卡因在分娩时的相对效价和临床特征。在一项随机双盲研究中，60例在产程早期要求硬膜外镇痛的ASA I或II级初产妇被分配接受通过患者自控镇痛泵给予的0.1%罗哌卡因加0.0002%芬太尼或0.1%左旋布比卡因加0.0002%芬太尼。用15 ml研究溶液建立镇痛，并使用5 ml研究溶液推注维持，锁定间隔为5分钟。两组之间在镇痛起效时间、持续时间和质量、运动和感觉阻滞、局部麻醉药用量、分娩方式、新生儿结局或产妇满意度方面均无显著差异。我们得出结论，0.1%罗哌卡因加0.0002%芬太尼和0.1%左旋布比卡因加0.0002%芬太尼在分娩镇痛方面在临床上难以区分，并且在使用PCEA时似乎药理学效价相当。
