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https://www.readbyqxmd.com/read/15702062/high-volume-of-subarachnoid-levobupivacaine-decreases-drug-requirement-in-first-stage-labor-analgesia
#1
RANDOMIZED CONTROLLED TRIAL
R Parpaglioni, M G Frigo, M Sebastiani, A Lemma, G Barbati, D Celleno
AIM: Using the statistic method of sequential allocation, we realized a prospective double-blind study in order to establish the minimum local anesthetic concentration (MLAC) of large intrathecal volume of levobupivacaine, during the first stage labour analgesia in spontaneous and induced laboring women. METHODS: Seventy-five nulliparous, at term, with cervical dilatation <5 cm parturients requesting combined spinal/epidural analgesia, were enrolled. The starting concentration was chosen according to recent literature...
December 2004: Minerva Anestesiologica
https://www.readbyqxmd.com/read/15321309/determination-of-the-minimum-local-analgesic-concentration-of-epidural-chloroprocaine-hydrochloride-in-labor
#2
M O Columb, G Lyons, N N Naughton, W W Becton
The aim was to determine the effective concentration in 50% of patients (EC(50)) of chloroprocaine in the first stage of labor. A constant dose modification of a model where EC(50) was previously defined as the minimum local analgesic concentration (MLAC) was used. Parturients (n = 36) requesting epidural analgesia in labor, at cervical dilatation not exceeding 7 cm, were enrolled into this prospective, double-blinded study. After placing a lumbar epidural catheter, chloroprocaine 150 mg diluted to the concentration being evaluated was given...
January 1997: International Journal of Obstetric Anesthesia
https://www.readbyqxmd.com/read/14570676/the-relative-motor-blocking-potencies-of-bupivacaine-and-levobupivacaine-in-labor
#3
RANDOMIZED CONTROLLED TRIAL
Héctor J Lacassie, Malachy O Columb
UNLABELLED: Minimum local analgesic concentrations (MLAC) have been used to determine the epidural analgesic potencies of bupivacaine and its levo- counterpart. There are no reports of the motor blocking potencies of these drugs. In this study we sought to determine the motor block MLAC of both drugs and determine the relative potency ratio. Sixty ASA physical status I-II parturients were randomized. The first woman in each group received 0.25% wt/vol. Up-down sequential allocation was used to determine subsequent concentrations at a testing interval of 0...
November 2003: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/14570662/the-site-of-action-of-epidural-fentanyl-infusions-in-the-presence-of-local-anesthetics-a-minimum-local-analgesic-concentration-infusion-study-in-nulliparous-labor
#4
RANDOMIZED CONTROLLED TRIAL
Yehuda Ginosar, Malachy O Columb, Sheila E Cohen, Edward Mirikatani, Martha S Tingle, Emily F Ratner, Martin S Angst, Edward T Riley
UNLABELLED: We have previously demonstrated that continuous epidural infusions of fentanyl without local anesthetics elicit analgesia by a systemic mechanism. In this study, we examined the hypothesis that, in the presence of epidural bupivacaine, continuous infusions of epidural fentanyl elicit analgesia by a spinal mechanism. Forty-eight nulliparous women in active labor participated in this prospective, randomized, double-blinded study. Women received lumbar epidural analgesia with 20-30 mL bupivacaine 0...
November 2003: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/12657859/local-anesthetic-requirements-are-greater-in-dystocia-than-in-normal-labor
#5
COMPARATIVE STUDY
Moeen K Panni, Scott Segal
BACKGROUND: Dystocia is characterized by abnormal progress of labor and is a common contemporary indication for cesarean delivery in the United States. There has been considerable controversy as to whether epidural analgesia causes dysfunctional labor leading to cesarean delivery for dystocia. The minimum local analgesic concentration (MLAC) is a clinical model used to determine the relative potencies of local anesthetics in the first stage of labor. In this article, the authors report a prospective study determining the MLAC of bupivacaine in early labor of parturients who eventually delivered either vaginally or via cesarean section...
April 2003: Anesthesiology
https://www.readbyqxmd.com/read/12486584/-analgesia-during-labour-from-taboo-to-evidence-based-medicine
#6
REVIEW
M C Schneider
Peripartum care of parturients has contributed a great deal to the development of modern anaesthesia during the past 150 years. The introduction of general and regional anaesthesia provided new options of relieving pain during delivery and preventing suffering. However,provision of effective labor analgesia gave and still gives rise to controversy as to whether interfering with natural events such as delivery was justifiable on a religious,moral or ideological level. A new era of obstetric pain relief was initiated when a study design was devised to define the Minimum Local Analgesic Concentration (MLAC) needed for epidural analgesia...
December 2002: Der Anaesthesist
https://www.readbyqxmd.com/read/12198062/the-effect-of-clonidine-on-the-minimum-local-analgesic-concentration-of-epidural-ropivacaine-during-labor
#7
RANDOMIZED CONTROLLED TRIAL
Chritophe Aveline, Sonia El Metaoua, Anis Masmoudi, Pierre-Yves Boelle, Francis Bonnet
UNLABELLED: On the basis of the determination of minimum local analgesic concentration (MLAC), ropivacaine has been demonstrated to be less potent than bupivacaine during the first stage of labor. In this study we assessed the effect of clonidine on the MLAC of ropivacaine. Seventy-seven parturients of mixed parity requesting epidural analgesia for labor (cervical dilation, 3-7 cm) were included in the study. They received an epidural bolus of either ropivacaine (n = 30), ropivacaine plus clonidine 30 microg (n = 28), or ropivacaine plus clonidine 60 microg (n = 19) in the second part of the study...
September 2002: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/12088969/the-relative-motor-blocking-potencies-of-epidural-bupivacaine-and-ropivacaine-in-labor
#8
RANDOMIZED CONTROLLED TRIAL
Héctor J Lacassie, Malachy O Columb, Héctor P Lacassie, Rodrigo A Lantadilla
UNLABELLED: Minimal local analgesic concentrations (MLAC) have been used to determine the epidural analgesic potencies of bupivacaine and ropivacaine. There are no reports of the motor blocking potencies of these drugs. We sought to determine the motor block MLAC of both drugs and their relative potency ratio. Sixty ASA physical status I and II parturients were randomized to one of two groups, during the first stage of labor. Each received a 20-mL bolus of epidural bupivacaine or ropivacaine...
July 2002: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/11981152/effect-of-epidural-epinephrine-on-the-minimum-local-analgesic-concentration-of-epidural-bupivacaine-in-labor
#9
RANDOMIZED CONTROLLED TRIAL
Linda S Polley, Malachy O Columb, Norah N Naughton, Deborah S Wagner, Cosmas J M van de Ven
BACKGROUND: The minimum local analgesic concentration (MLAC) has been defined as the median effective local analgesic concentration in a 20-ml volume for epidural analgesia in the first stage of labor. The aim of this study was to determine the local anesthetic-sparing efficacy of epidural epinephrine by its effect on the MLAC of bupivacaine. METHODS: In this double-blind, randomized, prospective study, 70 parturients who were at 7 cm or less cervical dilation and who requested epidural analgesia were allocated to one of two groups...
May 2002: Anesthesiology
https://www.readbyqxmd.com/read/11159242/levobupivacaine-for-epidural-analgesia-in-labor-the-sparing-effect-of-epidural-fentanyl
#10
RANDOMIZED CONTROLLED TRIAL
A P Robinson, G R Lyons, R C Wilson, H J Gorton, M O Columb
Evidence suggests that levobupivacaine has similar pharmacodynamic properties to racemic bupivacaine. We sought to investigate whether this similarity extends to opioid sparing when levobupivacaine is used for epidural analgesia in laboring women by quantifying the effect of fentanyl on the minimum local analgesic concentration (MLAC) of levobupivacaine. One-hundred-six women requesting epidural analgesia for labor pain were recruited in this randomized, double-blinded, up-down sequential allocation study. Each received 20 mL of one of three test solutions: levobupivacaine control, levobupivacaine and fentanyl 2 microg/mL, or levobupivacaine and fentanyl 3 microg/mL...
February 2001: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/10861155/effect-of-intravenous-versus-epidural-fentanyl-on-the-minimum-local-analgesic-concentration-of-epidural-bupivacaine-in-labor
#11
RANDOMIZED CONTROLLED TRIAL
L S Polley, M O Columb, N N Naughton, D S Wagner, D M Dorantes, C J van de Ven
BACKGROUND: The minimum local analgesic concentration (MLAC) has been defined as the median effective local analgesic concentration (EC50) in a 20-ml volume for epidural analgesia in the first stage of labor. The aim of this study was to determine the relative local anesthetic sparing efficacies of intravenous and epidural fentanyl by comparison of their effects on the MLAC of bupivacaine. METHODS: In this double-blind, randomized, prospective study, 84 parturients at < or = 7-cm cervical dilation who requested epidural analgesia were allocated to one of two groups...
July 2000: Anesthesiology
https://www.readbyqxmd.com/read/10201661/relative-analgesic-potencies-of-ropivacaine-and-bupivacaine-for-epidural-analgesia-in-labor-implications-for-therapeutic-indexes
#12
RANDOMIZED CONTROLLED TRIAL
L S Polley, M O Columb, N N Naughton, D S Wagner, C J van de Ven
BACKGROUND: The minimum local analgesic concentration (MLAC) has been defined as the median effective local analgesic concentration in a 20-ml volume for epidural analgesia in the first stage of labor. The aim of this study was to assess the relative analgesic potencies of epidural bupivacaine and ropivacaine by determining their respective minimum local analgesic concentrations. METHODS: Seventy-three parturients at < or = 7 cm cervical dilation who requested epidural analgesia were allocated to one of two groups in this double-blinded, randomized, prospective study...
April 1999: Anesthesiology
https://www.readbyqxmd.com/read/9743398/dose-dependent-reduction-of-the-minimum-local-analgesic-concentration-of-bupivacaine-by-sufentanil-for-epidural-analgesia-in-labor
#13
RANDOMIZED CONTROLLED TRIAL
L S Polley, M O Columb, D S Wagner, N N Naughton
BACKGROUND: The minimum local analgesic concentration (MLAC) has been defined as the median effective local analgesic concentration in a 20-ml volume for epidural analgesia in the first stage of labor. The aim of this study was to determine the local anesthetic-sparing efficacy of epidural sufentanil by its effect on the MLAC of bupivacaine. METHODS: In this double-blind, randomized, prospective study, 147 parturients at < or = 7 cm cervical dilation who requested epidural analgesia were allocated to one of four study groups...
September 1998: Anesthesiology
https://www.readbyqxmd.com/read/8895273/the-effect-of-epidural-fentanyl-on-the-minimum-local-analgesic-concentration-of-epidural-chloroprocaine-in-labor
#14
RANDOMIZED CONTROLLED TRIAL
L S Polley, M O Columb, G Lyons, S A Nair
The minimum local analgesic concentration (MLAC) has been defined as the median effective local analgesic concentration (EC50) in a 20-mL volume in the first stage of labor. The aim of this study was to determine the local anesthetic sparing efficacy of epidural fentanyl by its effect on the MLAC of chloroprocaine. Fifty-six parturients, not exceeding 7 cm cervical dilation, who requested epidural analgesia were allocated to one of two groups in this double-blind, randomized, prospective study. After placing a lumbar epidural catheter, 20 mL of the solution being tested was given: chloroprocaine (n = 28) or chloroprocaine with fentanyl 3 micrograms/mL (60 micrograms) (n = 28)...
November 1996: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/7574019/determination-of-the-minimum-local-analgesic-concentrations-of-epidural-bupivacaine-and-lidocaine-in-labor
#15
RANDOMIZED CONTROLLED TRIAL
M O Columb, G Lyons
The aim of this study was to devise a clinical model to determine the effective concentrations in 50% of patients (EC50) for bupivacaine and lidocaine in the first stage of labor and define EC50 as the minimum local analgesic concentration (MLAC). This should allow the determination of relative analgesic potency and, subsequently, the local anesthetic sparing efficacy of other epidural analgesics. Parturients not exceeding 5 cm cervical dilation who requested epidural analgesia were enrolled. The two studies involved 81 women (bupivacaine n = 41, lidocaine n = 40)...
October 1995: Anesthesia and Analgesia
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