Epidural infusion of alfentanil or diamorphine with bupivacaine in labour--a dose finding study. 1995

D A Hill, and G McCarthy, and I M Bali
Department of Anaesthetics, Waveney Hospital, Ballymena, N. Ireland.

Following induction of epidural analgesia with 0.375% bupivacaine, 120 healthy parturients were randomly assigned in a double blind fashion to one of eight infusion groups. All received 8 ml.h-1 of 0.125% bupivacaine either alone (control group), or with alfentanil at 133, 266 or 400 micrograms.h-1 (groups A1-A3) or with diamorphine at 133, 266, 400 or 533 micrograms.h-1 (groups D1-D4). Significantly longer top-up intervals were achieved with the two highest doses of both alfentanil and diamorphine when compared with bupivacaine alone (p < 0.01), making the minimum effective doses 266 micrograms.h-1 of alfentanil and 400 micrograms.h-1 of diamorphine. Perineal analgesia was better in all the opioid groups compared with the control group (p < 0.05). The intensity of motor block was greater in the control group (p < 0.05). The incidence of pruritus did not differ between groups. The highest dose of diamorphine caused significantly more nausea. No significant neonatal side-effects were demonstrated.

UI MeSH Term Description Entries
D007743 Labor, Obstetric The repetitive uterine contraction during childbirth which is associated with the progressive dilation of the uterine cervix (CERVIX UTERI). Successful labor results in the expulsion of the FETUS and PLACENTA. Obstetric labor can be spontaneous or induced (LABOR, INDUCED). Obstetric Labor
D011247 Pregnancy The status during which female mammals carry their developing young (EMBRYOS or FETUSES) in utero before birth, beginning from FERTILIZATION to BIRTH. Gestation,Pregnancies
D002045 Bupivacaine A widely used local anesthetic agent. 1-Butyl-N-(2,6-dimethylphenyl)-2-piperidinecarboxamide,Bupivacain Janapharm,Bupivacain-RPR,Bupivacaina Braun,Bupivacaine Anhydrous,Bupivacaine Carbonate,Bupivacaine Hydrochloride,Bupivacaine Monohydrochloride, Monohydrate,Buvacaina,Carbostesin,Dolanaest,Marcain,Marcaine,Sensorcaine,Svedocain Sin Vasoconstr,Bupivacain RPR
D003932 Heroin A narcotic analgesic that may be habit-forming. It is a controlled substance (opium derivative) listed in the U.S. Code of Federal Regulations, Title 21 Parts 329.1, 1308.11 (1987). Sale is forbidden in the United States by Federal statute. (Merck Index, 11th ed) Diacetylmorphine,Diamorphine,Diacetylmorphine Hydrochloride,Diagesil,Diamorf,Heroin Hydrochloride,Min-I-Jet Morphine Sulphate,Hydrochloride, Diacetylmorphine,Hydrochloride, Heroin,Min I Jet Morphine Sulphate
D004305 Dose-Response Relationship, Drug The relationship between the dose of an administered drug and the response of the organism to the drug. Dose Response Relationship, Drug,Dose-Response Relationships, Drug,Drug Dose-Response Relationship,Drug Dose-Response Relationships,Relationship, Drug Dose-Response,Relationships, Drug Dose-Response
D004311 Double-Blind Method A method of studying a drug or procedure in which both the subjects and investigators are kept unaware of who is actually getting which specific treatment. Double-Masked Study,Double-Blind Study,Double-Masked Method,Double Blind Method,Double Blind Study,Double Masked Method,Double Masked Study,Double-Blind Methods,Double-Blind Studies,Double-Masked Methods,Double-Masked Studies,Method, Double-Blind,Method, Double-Masked,Methods, Double-Blind,Methods, Double-Masked,Studies, Double-Blind,Studies, Double-Masked,Study, Double-Blind,Study, Double-Masked
D005260 Female Females
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000293 Adolescent A person 13 to 18 years of age. Adolescence,Youth,Adolescents,Adolescents, Female,Adolescents, Male,Teenagers,Teens,Adolescent, Female,Adolescent, Male,Female Adolescent,Female Adolescents,Male Adolescent,Male Adolescents,Teen,Teenager,Youths
D000328 Adult A person having attained full growth or maturity. Adults are of 19 through 44 years of age. For a person between 19 and 24 years of age, YOUNG ADULT is available. Adults

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