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British Journal of Anaesthesia, Vol 76, Issue 1 66-71, Copyright © 1996 by The Board of Management and Trustees of the British Journal of Anaesthesia

CLINICAL INVESTIGATIONS

A double-blind comparison of 0.25% ropivacaine and 0.25% bupivacaine for extradural analgesia in labour

J. M. Eddleston, J. J. Holland, R. P. Griffin, A. Corbett, E. L. Horsman and F. Reynolds
Department of Anaesthesia, Manchester Royal Infirmary, Oxford Road, Manchester M13 9WL; Department of Anaesthesia, St Thomas' Hospital, Lambeth Palace Road, London SE1 7EH; Department of Anaesthesia, Freeman Hospital, Newcastle upon Tyne; Department of Anaesthesia, Guy's Hospital, St Thomas's Street, London SE1 9RT

Ropivacaine is a new aminoamide local anaesthetic. Compared with bupivacaine, ropivacaine possesses a higher threshold for systemic toxicity and a high selectivity for sensory fibres. We have compared prospectively these two agents in a concentration of 0.25% for extradural analgesia in labour. A total of 104 parturients requesting extradural analgesia were randomized to receive either ropivacaine or bupivacaine. The women in the bupivacaine group required more top-up doses to maintain analgesia (median 3.0 vs 2.0) (P < 0.05). The onset of sensory block, quality of analgesia, ultimate level of maximum sensory block and maternal satisfaction were similar in both groups. The incidence, intensity and duration of motor block were slightly but not significantly less in the ropivacaine group. The ropivacaine group had a higher incidence of spontaneous vaginal delivery (70.59% vs 52.00%). There was no significant difference in neonatal outcome as assessed by Apgar scores, umbilical acid-base status and neurological and adaptive capacity score at 2 and 24 h after delivery. We conclude that ropivacaine and bupivacaine in a concentration of 0.25% produced comparable analgesia for pain relief of labour with no detectable adverse effect on the neonate.
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