Addition of clonidine to a continuous patient-controlled epidural infusion of low-concentration levobupivacaine plus sufentanil in primiparous women during labour

Anaesthesia. 2011 Sep;66(9):769-79. doi: 10.1111/j.1365-2044.2011.06785.x. Epub 2011 Jun 24.

Abstract

We studied the potentiation of analgesia for labour by the addition of clonidine to epidural low-concentration levobupivacaine with sufentanil in a randomised, double-blinded study. We enrolled primiparous women who were in spontaneous labour. The study solutions, made of 100 ml levobupivacaine 0.0625% plus sufentanil 0.45 μg.ml(-1) and either 150 μg clonidine or no clonidine, were used for induction of analgesia, and for its maintenance with self-administered boluses and a continuous background infusion. The need for additional epidural boluses during labour was lower and analgesia and maternal satisfaction were better in the clonidine (n = 57) than in the control group (n = 58). Blood pressure was lower and the rate of instrumental delivery higher in the clonidine group. Clonidine (1.36 μg.ml(-1)) added to the epidural solution of low-concentration levobupivacaine improves the quality of analgesia. The relevance of the haemodynamic effects should be explored in larger validation studies.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Adult
  • Analgesia, Epidural*
  • Analgesia, Obstetrical*
  • Analgesia, Patient-Controlled*
  • Analgesics, Opioid / administration & dosage*
  • Anesthetics, Local / administration & dosage*
  • Bupivacaine / administration & dosage
  • Bupivacaine / analogs & derivatives
  • Clonidine / administration & dosage*
  • Double-Blind Method
  • Female
  • Hemodynamics / drug effects
  • Humans
  • Levobupivacaine
  • Pregnancy
  • Sufentanil / administration & dosage*

Substances

  • Analgesics, Opioid
  • Anesthetics, Local
  • Levobupivacaine
  • Sufentanil
  • Clonidine
  • Bupivacaine