Choice of Local Anesthetic for Labor and Delivery— Bupivacaine, Ropivacaine and Levobupivacaine

Author(s):  
Stephen H. Halpern
1996 ◽  
Vol 84 (1) ◽  
pp. 88-93 ◽  
Author(s):  
Robert D'Angelo ◽  
Brenda L. Berkebile ◽  
J. C. Gerancher

Background Although it is generally accepted that inserting epidural catheters 3-4 cm into the epidural space minimizes complications, no prospective randomized examination of epidural catheter insertion length has been published. Methods Eight hundred healthy parturients requesting epidural analgesia were randomized to have open-tip epidural catheters inserted 2, 4, 6, or 8 cm within the epidural space. The incidences of intravenous cannulation, unilateral sensory analgesia, and subsequent catheter dislodgment were recorded. Catheter insertions that resulted in intravenous cannulation or unilateral analgesia were incrementally withdrawn and retested with additional local anesthetic to determine the effectiveness of epidural catheter manipulation. Results Epidural catheters inserted 8 cm within the epidural space were more likely to result in intravenous cannulation. Epidural catheters inserted 2 cm within the epidural space were less likely to result in unilateral sensory analgesia but were more likely to become dislodged. Twenty-three percent of epidural catheters inserted > 2 cm within the epidural space required manipulation. Epidural catheters inserted 2 or 4 cm required replacement more often than epidural catheters inserted 6 or 8 cm. Ninety-one percent and 50% of epidural catheters that resulted in unilateral sensory analgesia and intravenous cannulation, respectively, provided analgesia for labor and delivery after incremental withdrawal. Conclusions Epidural catheters should be inserted either 2 cm when rapid labor is anticipated or 6 cm when prolonged labor or cesarean delivery is likely. Additionally, epidural catheters that result in intravenous cannulation or unilateral sensory analgesia can be manipulated effectively to provide analgesia for labor and delivery.


2012 ◽  
Vol 3 (4) ◽  
pp. 209-211
Author(s):  
Dr.T.Jayasree Dr.T.Jayasree ◽  
◽  
Dr Shaikh Ubedulla ◽  
Dr. Chandrasekhar Nutalapati ◽  
Naveen Aalasyam ◽  
...  

2016 ◽  
Vol 65 (11) ◽  
Author(s):  
Christine K. Olson ◽  
Martha Iwamoto ◽  
Kiran M. Perkins ◽  
Kara N.D. Polen ◽  
Jeffrey Hageman ◽  
...  

2014 ◽  
Vol 76 (3) ◽  
pp. 222-224 ◽  
Author(s):  
Hiroko TSURU ◽  
Hiroshi UCHI ◽  
Reiko ITO ◽  
Misa NAKANO ◽  
Futoshi KODA ◽  
...  

2016 ◽  
Vol 4 (1) ◽  
pp. 17
Author(s):  
Rodica Sîrbu ◽  
Emin Cadar ◽  
Cezar Laurențiu Tomescu ◽  
Cristina Luiza Erimia ◽  
Stelian Paris ◽  
...  

Local anesthetics are substances which, by local action groups on the runners, cause loss of reversible a painful sensation, delimited corresponding to the application. They allow small surgery, short in duration and the endoscopic maneuvers. May be useful in soothe teething pain of short duration and in the locking of the nervous disorders in medical care. Local anesthesia is a process useful for the carrying out of surgery and of endoscopic maneuvers, to soothe teething pain in certain conditions, for depriving the temporary structures peripheral nervous control. Reversible locking of the transmission nociceptive, the set of the vegetative and with a local anesthetic at the level of the innervations peripheral nerve, roots and runners, a trunk nervous, around the components of a ganglion or coolant is cefalorahidian practice anesthesia loco-regional. Local anesthetics summary and semi-summary have multiple applications in dentistry, consulting, surgery and obstetrics, constituting "weapons" very useful in the fight against the pain.


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