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0.2% ropivacaine and levobupivacaine provide equally effective epidural labour analgesia

[La ropivacaïne et la lévobupivacaïne à 0,2 % par voie épidurale ont un effet analgésique similaire pendant le travail]

From the Department of Anesthesia O & G, Kandang Kerbau Hospital, Singapore.

Address correspondence to: Dr. Mia Supandji, Department of Anesthesia O & G, KK Women and Children Hospital, 100 Bukit Timah Road, Singapore. E-mail: athsia{at}kkh.com.sg

Purpose: To compare the duration of epidural analgesia induced by levobupivacaine and ropivacaine at clinically relevant doses.

Methods: Forty healthy nulliparous parturients with cervical dilatation of 3 to 5 cm and at least one contraction every two or three minutes were recruited. Patients were randomly assigned to receive either 10 mL of 0.2% ropivacaine or 10 mL of 0.2% levobupivacaine. Preblock visual analogue scale (VAS) score (0–100) and VAS score after five, ten, 15, 20, 25 and 30 min from time₀ and VAS at time of request for additional analgesia (time_end) were recorded.

During the first 30 min after the completion of epidural injection, the systolic blood pressure, highest sensory level to cold and the maximum degree of motor block based on a 0 to 3 modified Bromage scale were collected every five minutes. The duration of analgesia was defined as the time from time₀ to time_end.

Results: There was no difference in the duration of analgesia between the two groups; similarly, there was no significant difference found in the area under the curve (AUC) time₁₅-time₀ and AUC time₃₀-time₀ for VAS. The highest sensory block to cold and the degree of motor block were also indistinguishable between the two groups. No difference in the serial systolic blood pressures was found.

Conclusion: Ten millilitres of either 0.2% ropivacaine or levobupivacaine can be used to induce epidural labour analgesia effectively without a difference in the duration of pain relief.