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• W2021519251 abstract "Ropivacaine is a novel, long-acting, single S-(-)-en-antiomer, amide local anaesthetic. While ropivacaine is structurally closely related to bupivacaine, it has been shown to have less CNS and cardiac toxicity than bupivacaine. It has increased local anaesthetic/toxicity (therapeutic) and convulsion/lethal dose ratios. This study was undertaken to investigate the efficacy of epidurally-administered, preservative-free ropivacaine 0.25% without adrenaline on pain relief, haemodynamic parameters and motor and sensory blockade during labour. Bupivacaine 0.25%, which has equivalent sensory analgesic efficacy, was used as the active control. Seventy-seven, ASA I & II parturients with full-term (≥37/40, ≤42/40 wks) singleton pregnancies in whom epidural analgesia was planned were randomized to the two groups. The initial dose consisted of a 5 mL (12.5 mg) test dose, a 5 mL main dose and an optional 5 mL additional dose of study drug. Up to eight top-up doses of 10 mL each were allowed. Maximum allowable dose of drug was 95 mL (237.5 mg) in 24 h, with no more than 175 mg to be given over a 3 hour period. Seventy-six mothers (38 in each group) were valid for efficacy and safety analysis. Uterine contractions and fetal heart rate were monitored continuously until delivery. At each contraction after the main dose, pain relief was assessed using a verbal pain relief scale to obtain the time of onset of pain relief. Contraction pain was assessed using a visual analogue scale (VAS) and a verbal pain score every 15 min until delivery. Overall quality of analgesia was also assessed by both the patient and the investigator. Maternal blood pressure and heart rate and fetal heart rate were measured at 5, 10, 15, 20, 35 & 50 min and, thereafter, every 30 min after the main dose and after each top-up dose. Degree of motor block at the hip, knee and ankle and bilateral upper sensory level to pin-prick were measured every 30 min until normal motor power and sensation respectively returned. Ropivacaine produced a lower maximum degree of motor block (P<0.05) than bupivacaine. Parturients receiving ropivacaine needed fewer top-ups than those receiving bupivacaine (P<0.05). Duration of labour and times from main dose to transition to stage II of labour (2.0 vs. 3.1 h) were shorter and mean total dose of drug was smaller in the ropivacaine group. Pain relief was excellent in both groups but ropivacaine produced significantly less motor block than bupivacaine." @default.
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• W2021519251 title "Pain relief and sensory and motor block in mothers receiving epidural ropivacaine 0.25% and bupivacaine 0.25% for analgesia during labour - a double blind parallel, randomized comparison of efficacy" @default.
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