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  • Title: [Analgesic effectiveness and repercussions on the progress of labor of small doses of bupivacaine and fentanyl in continuous peridural perfusion].
    Author: García-Muñoz M, López-Vidal J, Sevila-Pascual MA, Alonso-Miranda B, Cárceles-Barón MD, Canteras-Jordana M, López-Rodríguez F.
    Journal: Rev Esp Anestesiol Reanim; 1997 Apr; 44(4):135-9. PubMed ID: 9244939.
    Abstract:
    OBJECTIVES: To compare the analgesic efficacy and repercussion on labor of early administration of two different concentrations of bupivacaine/fentanyl in continuous epidural perfusion, in comparison with a control group receiving no epidural anesthesia. PATIENTS AND METHODS: One hundred fifty patients were distributed among 3 groups. Group I (n = 50) received no epidural analgesia. Group II (n = 50) and III (n = 50) received test doses of 3 ml of bupivacaine plus adrenalin 1/200,000. After 5 minutes each patient in the study groups received 13 ml of the solution assigned (group II: 0.04% bupivacaine plus adrenalin 1/2,500,000 and fentanyl 2.5 micrograms/ml; group III: 0.0625% bupivacaine plus adrenalin 1/1,600,000 and fentanyl 2 micrograms/ml). Five minutes later a perfusion of 12 ml/h-1 of the same solution was delivered until dilation was complete. RESULTS: Epidural perfusion was started at 2.5 +/- 0.93 cm of dilation (group II) and 2.3 +/- 0.92 cm (group III). There were no statistically significant differences in either duration of labor until full dilation or expulsion among the groups. Pain assessed on a visual analog scale evolved from a baseline mean of 4.5 to 5 in the three groups, reaching 8.9 +/- 0.74 (group I), 0.24 +/- 0.89 (group II) and 0.28 +/- 0.57 (group III). There were no significant differences in fetal presentation or Apgar scores among the three groups at the end of delivery. CONCLUSION: Both solutions provide good analgesia during labor with minimum undesirable side effects. Low epidural doses of bupivacaine and fentanyl started early do not affect the course of labor.
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