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Minimum local anaesthetic dose (MLAD) of intrathecal levobupivacaine and ropivacaine for Caesarean section *
Author(s) -
Parpaglioni R.,
Frigo M. G.,
Lemma A.,
Sebastiani M.,
Barbati G.,
Celleno D.
Publication year - 2006
Publication title -
anaesthesia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.839
H-Index - 117
eISSN - 1365-2044
pISSN - 0003-2409
DOI - 10.1111/j.1365-2044.2005.04380.x
Subject(s) - levobupivacaine , ropivacaine , medicine , anesthesia , caesarean section , intrathecal , bupivacaine , spinal anesthesia , local anaesthetic , surgery , pregnancy , biology , genetics
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.