• C Fernández, X Sala, A Plaza, A López, M Celemín, and C Gomar.
• Servicio de Anestesiología y Reanimación, Corporació Sanitaria Clínic, Universitat de Barcelona. cfernan8@terra.es
• Rev Esp Anestesiol Reanim. 2003 Feb 1;50(2):70-6.

ObjectiveTo compare the analgesic efficacy and extent of motor block when 0.125% ropivacaine or 0.125% bupivacaine were given in continuous perfusion through an epidural catheter during labor.Patients And MethodsWe studied 60 ASA I-II women, each carrying a single fetus at full term and in spontaneous labor. The patients were distributed in 2 groups. Women in the ropivacaine group (R) (n = 30) received 8 mL of 0.2% ropivacaine for analgesic induction, followed by a continuous perfusion of 10 mL/h at 0.125%. The bupivacaine group (B) (n = 30) received bupivacaine at the same concentration and infusion rate. The objective of analgesia was to achieve a score less than 3 on a visual analog pain scale. If analgesia was inadequate, a 5 mL bolus of 0.2% ropivacaine or bupivacaine, depending on group, was administered. The motor block was evaluated on an abbreviated Bromage scale and we recorded hemodynamic stability, fetal status, type of delivery and the total dose of local anesthetic.ResultsAnalgesia and hemodynamics were similar in both groups. Group R required a larger number of additional boluses, although the difference was not statistically significant. A motor block was observed in 8 patients in group B and 1 in group R (p < 0.05). Fetal status was similar in both groups.ConclusionBoth drugs were equally effective for controlling the pain accompanying labor, such that ropivacaine offered no advantage over bupivacaine in that regard. Ropivacaine's reduced motor block effect at the doses administered may offer an advantage in some situations, such as when a walking epidural is provided.

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