PubMed Health⌕ Search

Biomedical subjects

Linda S Polley

Publications and source records attributed to Linda S Polley.

7 recordsLinked to original sources
PubMed2003

Relative analgesic potencies of levobupivacaine and ropivacaine for epidural analgesia in labor.

BACKGROUND: The minimum local analgesic concentration has been defined as the median effective local analgesic concentration (EC50) in a 20-ml volume for epidural analgesia in the first stage of labor. The aim of this study was to assess the relative analgesic potencies of epidural levobupivacaine and ropivacaine by determination of their respective minimum local analgesic concentrations. METHODS: Parturients at 7 cm of cervical dilation or less who requested epidural analgesia were allocated to one of two groups in this double-blind, randomized, prospective study. After lumbar epidural catheter placement, 20 ml of the test solution was given: levobupivacaine (n = 35) or ropivacaine (n = 35). The concentration of local anesthetic was determined by the response of the previous patient in that group to a higher or lower concentration using up-down sequential allocation. Analgesic efficacy was assessed using 100-mm visual analog pain scale scores, with 10 mm or less within 30 min defined as effective. An effective result directed a 0.01% wt/vol decrement for the next patient. An ineffective result directed a 0.01% wt/vol increment. RESULTS: Of 105 women enrolled, 35 were excluded, leaving 70 for analysis. The minimum local analgesic concentration of levobupivacaine was 0.087% wt/vol (95% CI, 0.081-0.094%), and the minimum local analgesic concentration of ropivacaine was 0.089% wt/vol (95% CI, 0.075-0.103%). Levobupivacaine and ropivacaine were of similar potency with a ropivacaine:levobupivacaine potency ratio of 0.98 (95% CI, 0.80-1.20). No difference in motor effects was observed. CONCLUSIONS: This study demonstrated that levobupivacaine and ropivacaine are of similar potency for epidural analgesia in the first stage of labor.

Adult↗
PubMed2002

Effect of epidural epinephrine on the minimum local analgesic concentration of epidural bupivacaine in labor.

BACKGROUND: The minimum local analgesic concentration (MLAC) has been defined as the median effective local analgesic concentration in a 20-ml volume for epidural analgesia in the first stage of labor. The aim of this study was to determine the local anesthetic-sparing efficacy of epidural epinephrine by its effect on the MLAC of bupivacaine. METHODS: In this double-blind, randomized, prospective study, 70 parturients who were at 7 cm or less cervical dilation and who requested epidural analgesia were allocated to one of two groups. After lumbar epidural catheter placement, 20 ml bupivacaine (n = 35) or bupivacaine with epinephrine 1:300,000 (n = 35) was administered. The concentration of bupivacaine was determined by the response of the previous patient in that group to a higher or lower concentration using up-down sequential allocation. Analgesic efficacy was assessed using 100-mm visual analog pain scores, with 10 mm or less within 30 min defined as effective. RESULTS: The MLAC of bupivacaine alone was 0.091% wt/vol (95% confidence interval, 0.081-0.102). The addition of epinephrine 1:300,000 (66.7 microg) resulted in a significant reduction (P < 0.01) in the MLAC of bupivacaine to 0.065% wt/vol (95% confidence interval, 0.047-0.083). The lowest maternal blood pressure was significantly lower in the bupivacaine-epinephrine group (P = 0.03). There were statistically significant reductions in fetal heart rate (P = 0.011) in the bupivacaine-epinephrine group that were not clinically significant. CONCLUSIONS: The addition of epidural epinephrine 1:300,000 (66 microg) resulted in a significant 29% reduction in the MLAC of bupivacaine. Coincident reductions in fetal heart rate and maternal blood pressure were also observed that were not clinically significant.

Adult↗
PubMed2002

EXIT to ECMO.

Explore the source record for details and available documents.

Adult↗