Comparison of bupivacaine 0.2% and ropivacaine 0.2% combined with fentanyl for epidural analgesia during labour

Aslk, I.; Göktüğ, Aytaç; Gülay, I.; Alkış, Neslihan; Uysalel, Asuman

doi:10.1017/s026502150200042x

Cited by 17 publications

(18 citation statements)

References 23 publications

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“…These cocktails have been shown to be effective in the acute perioperative period but have finite periods of action. Traditional amide local anesthetics such as bupivacaine or ropivacaine (which is reported to have a faster onset than bupivacaine but with a similar duration of action [2,7,11,12,22,25,37,41,50,52,55,58,74,86]) have been the mainstay of most TKA PAI cocktails. In addition to amide local anesthetics, some investigators have chosen to also include intrathecal morphine as part of their pain management protocol.…”

Section: Introductionmentioning

confidence: 99%

No Difference in Early Analgesia Between Liposomal Bupivacaine Injection and Intrathecal Morphine After TKA

Barrington

Emerson

Lovald

et al. 2017

Clinical Orthopaedics &Amp; Related Research

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Background Opioid analgesics have been a standard modality for postoperative pain management after total knee arthroplasty (TKA) but are also associated with increased risk of nausea, pruritus, vomiting, respiratory depression, prolonged ileus, and cognitive dysfunction.There is still a need for a method of anesthesia that can deliver effective long-term postoperative pain relief without incurring the high cost and health burden of opioids and nerve blocks. Questions/purposes (1) Is liposomal bupivacaine-based periarticular injection (PAI) more effective than morphinebased spinal anesthesia or ropivacaine-based PAI in

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Section: Introductionmentioning

confidence: 99%

No Difference in Early Analgesia Between Liposomal Bupivacaine Injection and Intrathecal Morphine After TKA

Barrington

Emerson

Lovald

et al. 2017

Clinical Orthopaedics &Amp; Related Research

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“…7 Asik et al concluded that epidural bupivacaine 0.2% and ropivacaine 0.2% combined with fentanyl produced equivalent analgesia for pain relief during labor and delivery. 8 It is concluded that ropivacaine 0.2% combined with fentanyl 2 microg mL (-1) provided effective analgesia with significantly less motor block and need for an instrumental delivery than a bupivacaine/fentanyl combination at the same concentrations during labor and delivery.…”

Section: Discussionmentioning

confidence: 96%

Onset and duration of epidural analgesia with bupivacaine and bupivacaine plus fentanyl: a comparative study

Umapathy

Ayathullah

2017

Int J Res Med Sci

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Background: Bupivacaine has got the more cardiac toxicity due to high degree of protein binding. There have been many attempts for improving the duration and onset of epidural block. Fentanyl when administered epidurally was found to reduce the requirement of doses by double in some cases. The objective of the study was to compare the efficacy of bupivacaine plus fentanyl in terms of onset and duration of epidural analgesia. Methods: A clinical study was undertaken to evaluate the onset and duration of analgesia with bupivacaine and mixture of bupivacaine plus fentanyl when given epidurally for patients undergoing lower limb orthopedic surgeries. The study was undertaken in 50 patients who were divided into two groups of 25 each. The patients were undergoing surgery in orthopedic theatre at S. V. S. Medical College and Hospital. Patients studied comprised of both the sexes between the 18-55 years of age. Results: It is seen that the onset of analgesia was equal in both the groups 72% of patients in group II had excellent quality of intra operative analgesia compared to only 36% of patients in group I. This difference was found to be statistically significant (p<0.05). It was seen that none of the patients had analgesia of less than 1 hour 30 minutes. The two-segment regression time was uniformly distributed amongst the two groups. It was found that the incidence of intra operative complications like bradycardia, hypotension, nausea/vomiting were almost equal in both the groups. It was found that the duration of post-operative analgesia in patients of two groups was almost equal. Conclusions: Addition of fentanyl to bupivacaine was found to increase the quality of intra operative analgesia. Otherwise there was no added advantage over bupivacaine alone.Keywords: Analgesia, Bupivacaine, Complications, Fentanyl DOI: http://dx.doi.org/10.18203/2320-6012.ijrms20172995Umapathy P et al. Int J Res Med Sci. 2017 Jul;5(7):3103-3106 International Journal of Research in Medical Sciences | July 2017 | Vol 5 | Issue 7 Page 3104 may vary. It produces motor as well as sensory block. Ropivacaine is an analog of mepivacaine. It has a shorter duration of motor block and also a lower toxicity as compared to bupivacaine. 2Bupivacaine has got the more cardiac toxicity due to high degree of protein binding. There have been many attempts for improving the duration and onset of epidural block. There were attempts of addition of sodium bicarbonate in different concentrations, epinephrine, phenyl epinephrine etc. However ultimately it was clear that opioids can augment the effects of these local anesthetics for use in epidural space. Fentanyl when administered epidurally was found to reduce the requirement of doses by double in some cases. 3Even though opioids were found to be effective, they do have their own side effects. Itching, vomiting, nausea, hypotension and urinary retention are some of them. Alpha adrenergic agonists like clonidine can also be used instead of opioids. 4 When clonidine is added to opioids, it gives an a...

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“…Yet again, the two local anaesthetics have not been compared in equipotent doses. In Aşlk and colleagues' study [7], the doses compared are high by today's standards and no effects of the addition of fentanyl have been observed due to this relatively high dose used. Also in Pirbudak and colleagues [16], no significant differences were observed between the two drugs, even if they were used at a lower concentration, but fentanyl was added in a dose effective on its own and may have masked the differences in analgesia due to the local anaesthetic solutions.…”

mentioning

confidence: 93%

“…In this issue of the European Journal of Anaesthesiology, Aşlk and colleagues compare the effects of epidurally administered fentanyl combined with either bupivacaine 0.2% or ropivacaine 0.2% for the initiation and maintenance of analgesia during labour and delivery [7]. Their results suggest that epidural block using bupivacaine 0.2% or ropivacaine 0.2%, combined with fentanyl, produces equivalent analgesia for pain relief during labour and delivery.…”

mentioning

confidence: 99%

Ropivacaine and bupivacaine in obstetric analgesia

Capogna¹

2002

EJA

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Comparison of bupivacaine 0.2% and ropivacaine 0.2% combined with fentanyl for epidural analgesia during labour

Cited by 17 publications

References 23 publications

No Difference in Early Analgesia Between Liposomal Bupivacaine Injection and Intrathecal Morphine After TKA

No Difference in Early Analgesia Between Liposomal Bupivacaine Injection and Intrathecal Morphine After TKA

Onset and duration of epidural analgesia with bupivacaine and bupivacaine plus fentanyl: a comparative study

Ropivacaine and bupivacaine in obstetric analgesia

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