Epidural ropivacaine versus bupivacaine for cesarean sections: a system review and meta-analysis.

Item request has been placed! ×
Item request cannot be made. ×
loading   Processing Request
Read More Add to Saved list
  • Author(s): Kang T;Kang T; Tao J; Tao J; Wang X; Wang X; Liu Y; Liu Y; Jin D; Jin D
  • Source:
    The journal of maternal-fetal & neonatal medicine : the official journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians [J Matern Fetal Neonatal Med] 2024 Dec; Vol. 37 (1), pp. 2313356. Date of Electronic Publication: 2024 Feb 11.
  • Publication Type:
    Journal Article; Meta-Analysis; Review; Systematic Review
  • Language:
    English
  • Additional Information
    • Source:
      Publisher: Informa Healthcare Country of Publication: England NLM ID: 101136916 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1476-4954 (Electronic) Linking ISSN: 14764954 NLM ISO Abbreviation: J Matern Fetal Neonatal Med
    • Publication Information:
      Publication: London : Informa Healthcare
      Original Publication: Boca Raton : Parthenon Pub. Group, c2002-
    • Subject Terms:
      Anesthesia, Epidural*/methods ; Anesthesia, Epidural*/adverse effects ; Anesthesia, Obstetrical*/adverse effects ; Anesthesia, Obstetrical*/methods ; Bupivacaine*/administration & dosage ; Bupivacaine*/adverse effects ; Cesarean Section*/methods ; Ropivacaine*/administration & dosage; Female ; Humans ; Infant, Newborn ; Pregnancy ; Anesthetics, Local/administration & dosage ; Apgar Score ; Randomized Controlled Trials as Topic
    • Abstract:
      Introduction: It is still no consensus on the use of ropivacaine or bupivacaine in epidural anesthesia for cesarean section (CS), because their anesthetic potency and relative complications remains controversial. This system review and meta-analysis aimed to compare the efficacy of epidural ropivacaine and bupivacaine for elective CSs and investigate relative complications for parturients and neonates.
      Methods: We searched PubMed, MEDLINE, Embase, Cochrane Library, Science-Direct, and Google Scholar to June 30, 2023 for randomized controlled trials (RCTs), which compared epidural ropivacaine with bupivacaine for elective CSs. The success rate of epidural anesthesia (EA) was primary outcome. The secondary outcomes included onset times of sensory block, maternal side effects, neonatal Apgar scores and umbilical artery pH.
      Results: We analyzed 8 RCTs with 532 parturients. 0.75% ropivacaine is associated with a shorter onset time of sensory block than 0.5% bupivacaine (SMD = -0.43, 95% CI: -0.70 to -0.17; p  = .001). 0.5% ropivacaine resulted in a reduced nausea than 0.5% bupivacaine (RR = 0.49, 95% CI: 0.28 to 0.83; p  = .008). In addition, there were no significant difference between ropivacaine and bupivacaine groups in terms of success rate of epidural anesthesia, maternal side effects (hypotension, bradycardia, shivering), and neonatal Apgar scores and umbilical artery pH.
      Conclusions: The findings suggest that there were no significant difference between epidural ropivacaine and bupivacaine for elective CSs in terms of the success rate (85.9% vs. 83.5), maternal side effects (hypotension, bradycardia, shivering), and neonatal Apgar scores and umbilical artery pH. But compared with 0.5% bupivacaine, epidural 0.75% ropivacaine was mildly effective for reducing onset time of sensory block and 0.5% ropivacaine reduced the incidence of maternal nausea.
    • Contributed Indexing:
      Keywords: Epidural; bupivacaine; cesarean section; meta-analysis; ropivacaine
    • Accession Number:
      0 (Anesthetics, Local)
      Y8335394RO (Bupivacaine)
      7IO5LYA57N (Ropivacaine)
    • Publication Date:
      Date Created: 20240211 Date Completed: 20240807 Latest Revision: 20240823
    • Publication Date:
      20240823
    • Accession Number:
      10.1080/14767058.2024.2313356
    • Accession Number:
      38342577