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We evaluated a continuous epidural infusion containing bupivacaine 0.05% plus the opioid hydromorphone in 1830 women requesting pain relief during labor and delivery. The infusion provided effective analgesia with minimal adverse events for patients differing in parity and at varying stages of labor. Pain relief was maintained in most patients without the need for epidural reinforcement with more concentrated doses of local anesthetic.

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EsmololTo the Editor: I read with interest the recent editorial and original paper on the cardioselective beta blocker, esmolol. ~.a Chung's conclusion that esmolol 2 mg. kg -~ is effective in obtunding the haemodynamic response to laryngoscopy and intubation concurs with our findings in another stressful situation, electroconvulsive therapy. 3 As Chung's study involved the use of a rapid-sequence induction technique with high dosages of succinylcholine (1.5 mg. kg-~), it is important to consider the possible theoretical drug interaction. Both esmolol and succinylcholine are metabolized by esterases and their combined administration may be associated with prolonged duration of action.