Minimum local anaesthetic dose (MLAD) of intrathecal levobupivacaine and ropivacaine for Caesarean section

Summary We determined the minimum local anaesthetic dose (MLAD) of spinal levobupivacaine and ropivacaine for Caesarean section. Ninety women were randomly allocated to two groups and received 3 ml of study solution by a combined spinal/epidural technique. The initial dose was 12 mg for levobupivaca...

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Bibliographic Details
Published in:Anaesthesia 2006-02, Vol.61 (2), p.110-115
Main Authors: Parpaglioni, R., Frigo, M. G., Lemma, A., Sebastiani, M., Barbati, G., Celleno, D.
Format: Article
Language:English
Subjects:
Adult
Amides - administration & dosage
Amides - adverse effects
Anesthesia
Anesthesia, Epidural - methods
Anesthesia, Obstetrical - methods
Anesthesia, Spinal - methods
Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy
Anesthetics, Local - administration & dosage
Anesthetics, Local - adverse effects
Biological and medical sciences
Bupivacaine - administration & dosage
Bupivacaine - adverse effects
Bupivacaine - analogs & derivatives
Cesarean Section
Clinical trials
Dose-Response Relationship, Drug
Drug dosages
Epidemiologic Methods
Female
Humans
Hypotension - chemically induced
Intraoperative Complications
Medical sciences
Pain
Pain Measurement
Pregnancy
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Summary:Summary We determined the minimum local anaesthetic dose (MLAD) of spinal levobupivacaine and ropivacaine for Caesarean section. Ninety women were randomly allocated to two groups and received 3 ml of study solution by a combined spinal/epidural technique. The initial dose was 12 mg for levobupivacaine and 17 mg for ropivacaine groups. To be considered effective, a test solution had to achieve a visual analogue pain score (VAPS) of 30 mm or less at skin incision, uterine incision, birth, peritoneal closure, and at the end of surgery. Effective or ineffective responses determined, respectively, a 0.3 mg decrease or increase of the same drug for the next patient in the same group, using up–down sequential allocation. The MLAD of levobupivacaine was 10.58 mg (CI 95%: 10.08–11.09) and the MLAD of ropivacaine 14.22 mg (CI 95%: 13.67–14.77), using the Dixon and Massey formula. The potency ratio between spinal levobupivacaine and spinal ropivacaine was 1.34.
ISSN:0003-2409
1365-2044
DOI:10.1111/j.1365-2044.2005.04380.x