Evaluation of S1 motor block to determine a safe, reliable test dose for epidural analgesia

Abstract

We conclude that testing for SI motor block 10 min after epidural injection of bupivacaine 10 mg is a reliable test to detect accidental intrathecal injection in the obstetric population.

Comparison of 2 concentrations of levobupivacaine in postoperative patient-controlled epidural analgesia

“…The epidural catheter was directed cephalad for a distance of 4 cm and fixed to the back of the patient. As soon as the patient was in the supine position, a test dose of 3 mL 5 mg/mL levobupivacaine (Chirocaine, Abbott, Belgium) was injected to exclude subarachnoid positioning of the catheter as proposed by Murdoch et al [17] and Daoud et al [18].…”

Comparison of different concentrations of levobupivacaine for post‐operative epidural analgesia

“…The epidural catheter was directed cephalad for a distance of 4 cm and fixed to the back of the patient. As soon as the patient was in a supine position, a test dose of 3 ml of 5 mg/ml levobupivacaine (Chirocaine 1 , Abbott, Belgium) was injected through the catheter (14,15). Bilateral sensory anaesthesia was demonstrated by pinprick after the test dose.…”

Up-down studies: responding to dosing!

“…Daoud et al 47 performed an up-down study to estimate the intrathecal ED50 for motor block in 20 parturients and then studied an additional 62 women with higher doses to specifically estimate ED95. The ED95 estimated from the up-down data alone compared favourably with the final estimate with only a modest improvement in precision despite quadrupling the size of the study.…”