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Br J Anaesth. 2007 Jan;98(1):105-9.

Analgesia with sevoflurane during labour: i. Determination of the optimum concentration.

Author information

  • 1Magill Department of Anaesthesia, Imperial College London, Chelsea and Westminster Hospital, 369 Fulham Road, London W12 0HS, UK. sengyeo@hotmail.com

Abstract

BACKGROUND:

Sevoflurane has favourable physical qualities for inhaled analgesia during labour pain. The aim of this preliminary study was to identify its optimum concentration.

METHODS:

In this open-labelled escalating-dose study, 22 parturients in labour self-administered sevoflurane at 10 contractions using an Oxford Miniature Vaporiser. The inspired concentration was increased by 0.2% after each contraction from 0% to 1.4% or decreased if sedation occurred. Visual analogue scores (0-100 mm) for pain intensity, pain relief, sedation, mood and coping were measured after each contraction.

RESULTS:

The median (IQR [range]) pain relief and sedation scores increased from 44 (43-56 [4-93]) mm and 55 (43-56 [0-98]) mm at 0.2% sevoflurane, to 74 (72-78 [50-80]) mm and 71 (71-73 [33-97]) mm at 1.2% sevoflurane, respectively. Pain relief scores did not show any significant increase above 0.8% whilst sedation continued to increase, with excessive sedation occurring at 1.2% sevoflurane. No significant changes in other scores were measured.

CONCLUSIONS:

We concluded that the optimal sevoflurane concentration in labour was 0.8%. This concentration allows a safety margin and balances the risk of sedation with the benefit of pain relief in labour.

Comment in

PMID:
17158128
DOI:
10.1093/bja/ael326
[PubMed - indexed for MEDLINE]
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