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Addition of epinephrine to epidural bupivacaine infusions following initiation of labor analgesia with epidural fentanyl.

Publication ,  Journal Article
Connelly, NR; Freiman, JP; Lucas, T; Parker, RK; Raghunathan, K; Gibson, C; Katz, B; Iwashita, C
Published in: J Clin Anesth
June 2011

STUDY OBJECTIVE: To evaluate the analgesic effects of the addition of epinephrine to a bupivacaine epidural infusion in early labor after a fentanyl bolus, following a lidocaine-epinephrine test dose. DESIGN: Randomized, double-blinded study. SETTING: Labor suite of a tertiary care hospital. PATIENTS: 60 ASA physical status 1 and 2, laboring, nulliparous women. INTERVENTIONS: All laboring women received a 3 mL epidural test dose of 1.5% lidocaine with 1:200,000 epinephrine, followed by a fentanyl 100 μg bolus in 10 mL of diluent volume. Patients were randomized to receive one of two continuous epidural infusions: bupivacaine 0.625 mg/mL at 10 mL/hr (control group) or bupivacaine 0.625 mg/mL with epinephrine 5 μg/mL at 10 mL/hr (epinephrine group). MEASUREMENTS: Time to re-dose, pain scores, and side effects were recorded. MAIN RESULTS: The mean duration of satisfactory analgesia prior to re-dose was 159 ± 62 min for the control group and 221 ± 111 min for the epinephrine group (P < 0.02). Pain scores were significantly higher in the control group than the epinephrine group at two time periods: 2.5 hours and 4.5 hours (P < 0.04). CONCLUSIONS: The administration of 0.625 mg/mL bupivacaine with epinephrine 5 μg/mL at 10 mL/hr, compared with plain 0.625 mg/mL bupivacaine at 10 mL/hr, provided a longer time to re-dose, decreased pain scores at two time intervals, and had no significant difference in duration of labor or side effects.

Duke Scholars

Published In

J Clin Anesth

DOI

EISSN

1873-4529

Publication Date

June 2011

Volume

23

Issue

4

Start / End Page

265 / 269

Location

United States

Related Subject Headings

  • Young Adult
  • Time Factors
  • Pregnancy
  • Lidocaine
  • Humans
  • Fentanyl
  • Female
  • Epinephrine
  • Drug Therapy, Combination
  • Double-Blind Method
 

Citation

APA
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ICMJE
MLA
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Connelly, N. R., Freiman, J. P., Lucas, T., Parker, R. K., Raghunathan, K., Gibson, C., … Iwashita, C. (2011). Addition of epinephrine to epidural bupivacaine infusions following initiation of labor analgesia with epidural fentanyl. J Clin Anesth, 23(4), 265–269. https://doi.org/10.1016/j.jclinane.2010.09.005
Connelly, Neil Roy, Jorge P. Freiman, Tanya Lucas, Robert K. Parker, Karthik Raghunathan, Charles Gibson, Brennan Katz, and Chad Iwashita. “Addition of epinephrine to epidural bupivacaine infusions following initiation of labor analgesia with epidural fentanyl.J Clin Anesth 23, no. 4 (June 2011): 265–69. https://doi.org/10.1016/j.jclinane.2010.09.005.
Connelly NR, Freiman JP, Lucas T, Parker RK, Raghunathan K, Gibson C, et al. Addition of epinephrine to epidural bupivacaine infusions following initiation of labor analgesia with epidural fentanyl. J Clin Anesth. 2011 Jun;23(4):265–9.
Connelly, Neil Roy, et al. “Addition of epinephrine to epidural bupivacaine infusions following initiation of labor analgesia with epidural fentanyl.J Clin Anesth, vol. 23, no. 4, June 2011, pp. 265–69. Pubmed, doi:10.1016/j.jclinane.2010.09.005.
Connelly NR, Freiman JP, Lucas T, Parker RK, Raghunathan K, Gibson C, Katz B, Iwashita C. Addition of epinephrine to epidural bupivacaine infusions following initiation of labor analgesia with epidural fentanyl. J Clin Anesth. 2011 Jun;23(4):265–269.
Journal cover image

Published In

J Clin Anesth

DOI

EISSN

1873-4529

Publication Date

June 2011

Volume

23

Issue

4

Start / End Page

265 / 269

Location

United States

Related Subject Headings

  • Young Adult
  • Time Factors
  • Pregnancy
  • Lidocaine
  • Humans
  • Fentanyl
  • Female
  • Epinephrine
  • Drug Therapy, Combination
  • Double-Blind Method