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Study of Efficacy of Bupivacaine and Ropivacaine with Fentanyl in Epidural Labour Analgesia

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Introduction: Labour is a highly complex and personal process for every woman. Analgesic intervention is a matter of personal choice for delivery. Local anesthesia given as an epidural injection along with an opioid gives quicker analgesia without impeding motor activity. Bupivacaine and Ropivacaine are commonly employed drugs to provide efficient epidural analgesia in labour. Aims: To compare the efficacy of ropivacaine with fentanyl and bupivacaine with fentanyl given as continuous infusion in labour epidural analgesia. Materials and Methods: This was a prospective randomized control trial wherein 70 women in labour were studied. These 70 parturients were randomly put into two groups. Group A (n=35) received 12 ml of 0.125% ropivacaine as the initial bolus followed by 8 ml/hour infusion of 0.125% ropivacaine with 2 µg/ml fentanyl. Group B (n=35) received 12 ml of 0.125% bupivacaine as initial bolus followed by 8ml/hour infusion of 0.125% bupivacaine with 2 µg/ml fentanyl. Various parameters like duration of labour, mode of delivery, neonatal outcome and complications were noted and compared for both the groups. Results: Both the groups showed minimal fluctuations in pain that were clinically and statistically insignificant. The spontaneous deliveries were similar in both groups. The rate of instrument assisted delivery and caesarean delivery was similar in both groups. No adverse neonatal outcome (because of the drugs used) in the form of low APGAR scores or admission to NICU were noticed in both the groups. Motor block was not statistically significant. The incidence of complications was minimal and comparable in both groups. Conclusion: Ropivacaine used at lower concentration (0.125%) offers good pain relief equivalent to that of bupivacaine. Both the drugs give similar results as regards the duration of labour, mode of delivery, neonatal outcome and complications. Though ropivacaine is less potent than bupivacaine, its safety and efficacy is equivalent to bupivacaine.

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Introduction: Labour is a highly complex and personal process for every woman. Analgesic intervention is a matter of personal choice for delivery. Local anesthesia given as an epidural injection along with an opioid gives quicker analgesia without impeding motor activity. Bupivacaine and Ropivacaine are commonly employed drugs to provide efficient epidural analgesia in labour. Aims: To compare the efficacy of ropivacaine with fentanyl and bupivacaine with fentanyl given as continuous infusion in labour epidural analgesia. Materials and Methods: This was a prospective randomized control trial wherein 70 women in labour were studied. These 70 parturients were randomly put into two groups. Group A (n=35) received 12 ml of 0.125% ropivacaine as the initial bolus followed by 8 ml/hour infusion of 0.125% ropivacaine with 2 µg/ml fentanyl. Group B (n=35) received 12 ml of 0.125% bupivacaine as initial bolus followed by 8ml/hour infusion of 0.125% bupivacaine with 2 µg/ml fentanyl. Various parameters like duration of labour, mode of delivery, neonatal outcome and complications were noted and compared for both the groups. Results: Both the groups showed minimal fluctuations in pain that were clinically and statistically insignificant. The spontaneous deliveries were similar in both groups. The rate of instrument assisted delivery and caesarean delivery was similar in both groups. No adverse neonatal outcome (because of the drugs used) in the form of low APGAR scores or admission to NICU were noticed in both the groups. Motor block was not statistically significant. The incidence of complications was minimal and comparable in both groups. Conclusion: Ropivacaine used at lower concentration (0.125%) offers good pain relief equivalent to that of bupivacaine. Both the drugs give similar results as regards the duration of labour, mode of delivery, neonatal outcome and complications. Though ropivacaine is less potent than bupivacaine, its safety and efficacy is equivalent to bupivacaine.

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This page is a summary of: A Comparative Study of Efficacy of Bupivacaine and Ropivacaine with Fentanyl in Epidural Labour Analgesia, Indian Journal of Anaesthesia and Analgesia, January 2019, Red Flower Publication Private, Ltd.,
DOI: 10.21088/ijaa.2349.8471.6419.6.
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