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The Effect of Rate of Infusion on Continuous Epidural Analgesia for Labor and Delivery
  1. Eric T. Pierce, PHD, MD,
  2. Divina J. Santos, MD,
  3. Donald D. Denson, PHD,
  4. Hakan H. Edstrom, PHD and
  5. Scott K. Essell, CRNA
  1. From the Departments of Anesthesia and Obstetrics and Gynecology, University of Cincinnati College of Medicine, Cincinnati, Ohio


The authors previously reported that if a loading dose of 50 mg bupivacaine was followed by infusion of 0.0625% bupivacaine (12.5 mg/hr), supplemental doses to achieve satisfactory analgesia for labor and delivery were required in 50% of patients. The current study was done to determine whether increasing the dose from 12.5 to 25 mg/h would eliminate the need for supplemental injections. Twenty-three healthy parturients were randomly assigned to one of two groups—Group I: 0.125% bupivacaine at 20 ml/hr (25 mg/hr); or Group II: 0.25% bupivacaine at 10 ml/hr (25 mg/hr). Taking both groups together, the 50-mg bupivacaine loading dose followed by 25 mg/hr provided adequate analgesia for labor and delivery in 74% of the patients. Two parturients in Group I and three in Group II required supplemental boluses of 4 ml of 0.5% bupivacaine for delivery. Pharmacokinetic data were similar in both groups. Using a dose of 25 mg/hr resulted in 74% of the patients obtaining adequate analgesia for labor and delivery. This improvement over the 50% success rate in the previous study, was achieved without any evidence of toxicity.

  • Continuous epidural analgesia
  • Analgesia for labor and delivery

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