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Comparison of two different local anesthetic infusion methods (with or without opioids) for epidural analgesia after cesarean section delivery

  • Spanopoulos Konstantinos1
  • Papagiannopoulou Ofilia1
  • Kousidis Ioiannis P1
  • Anagnostou Georgios1
  • Zografidou Polixeni1
  • Tsiotsiou Maria1
  • Gogali Despoina1
  • Pinas Dimitrios1
  • Grenda Georgia1
  • Grigoriou Ioulia1
  • Goutziomitrou Evangelia1

1Anaesthesiology Department, Papageorgiou General Hospital, Thessaloniki, Greece

DOI: 10.22514/sv.2021.166 Vol.17,Issue S1,September 2021 pp.21-21

Submitted: 26 August 2021 Accepted: 06 September 2021

Published: 15 September 2021

*Corresponding Author(s): Spanopoulos Konstantinos E-mail:


Aim: The aim of this study was to compare the efficacy and safety between ropivacaine 0.25% and ropivacaine 0.2% combined with a 0.025 mg/kg morphine regimen, administered as a continuous epidural infusion for analgesia after cesarean section delivery.

Materials and methods: We compared 55 parturient women undergoing a cesarean section delivery with a combined spinal-epidural technique. All women received intrathecally 2–2.3 mL ropivacaine 0.75% combined with 0.3 mL fentanyl through a G27 needle. An epidural catheter was inserted immediately after spinal anesthesia. Two hours after the onset of spinal anesthesia a ropivacaine 0.25% continuous epidural infusion (7 mL/h) was administered in group A whereas a ropivacaine 0.2% combined with 0.025 morphine epidural infusion (7 mL/h) was administered in group B. The degree of motor and sensory block (using a Bromage and VAS score 1–10) were evaluated immediately after, 2 h, 4 h, 8 h and 12 h after the onset of continuous epidural infusion administration. We also evaluated all patients’ blood pressure (BP) and heart rate at the same time intervals.

Results: There were no statistically significant differences in hemodynamic parameters, sensory block or analgesic effect between the groups however there were differences in motor block (Bromage score in group A 0.7 ± 0.5 vs 0.2 ± 0.4 in group B, p = 0.002).

Conclusion: The use of a local anesthetic and morphine combination in group B provided efficient epidural analgesia accomplishing a lower motor blockade compared to group A.

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Spanopoulos Konstantinos,Papagiannopoulou Ofilia,Kousidis Ioiannis P,Anagnostou Georgios,Zografidou Polixeni,Tsiotsiou Maria,Gogali Despoina,Pinas Dimitrios,Grenda Georgia,Grigoriou Ioulia,Goutziomitrou Evangelia. Comparison of two different local anesthetic infusion methods (with or without opioids) for epidural analgesia after cesarean section delivery. Signa Vitae. 2021. 17(S1);21-21.


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