Addition of clonidine to a continuous patient-controlled epidural infusion of low-concentration levobupivacaine plus sufentanil in primiparous women during labour.
Author(s): Bazin M, Bonnin M, Storme B, Bolandard F, Vernis L, Lavergne B, Pereira B, Bazin JE, Duale C
Affiliation(s): Hospital Practitioner, CHU Clermont-Ferrand, Pole Anesthesie-Reanimation-Estaing, Gynecologie-Obstetrique-Reproduction Humaine, Clermont-Ferrand, France.
Publication date & source: 2011-09, Anaesthesia., 66(9):769-79. Epub 2011 Jun 24.
Publication type: Randomized Controlled Trial
We studied the potentiation of analgesia for labour by the addition of clonidine to epidural low-concentration levobupivacaine with sufentanil in a randomised, double-blinded study. We enrolled primiparous women who were in spontaneous labour. The study solutions, made of 100 ml levobupivacaine 0.0625% plus sufentanil 0.45 mug.ml(-1) and either 150 mug clonidine or no clonidine, were used for induction of analgesia, and for its maintenance with self-administered boluses and a continuous background infusion. The need for additional epidural boluses during labour was lower and analgesia and maternal satisfaction were better in the clonidine (n = 57) than in the control group (n = 58). Blood pressure was lower and the rate of instrumental delivery higher in the clonidine group. Clonidine (1.36 mug.ml(-1)) added to the epidural solution of low-concentration levobupivacaine improves the quality of analgesia. The relevance of the haemodynamic effects should be explored in larger validation studies. (c) 2011 The Authors. Anaesthesia (c) 2011 The Association of Anaesthetists of Great Britain and Ireland.