0.1% Ropivacaine with Fentanyl and 0.1% Bupivacaine with Fentanyl for Epidural Labor Analgesia

What is it about?

0.1% Ropivacaine with Fentanyl and 0.1% Bupivacaine with Fentanyl for Epidural Labor Analgesia

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Why is it important?

Objective: A randomized, double blind study to compare the analgesic efficacy, maternal and neonatal outcome of ropivacaine 0.1% and bupivacaine 0.1% both with fentanyl for labor epidural analgesia. Methods: Sixty term parturient of ASA Grade I & II with singleton pregnancy in vertex presentation and adequate cervical dilatation requesting painless labor were divided into two groups of 30 each. Group BF parturient received bupivacaine 0.1% with fentanyl 20 g and Group RF parturient received ropivacaine 0.1% with fentanyl 20 g as intermittent bolus doses epidurally. After written informed consent, epidural catheter was placed in L3-4/4-5 space followed by study drug administration and top up doses intermittently. Maternal hemodynamics, Visual Analogue Score (VAS), Foetal heart rate, sensory analgesia, motor block, neonatal APGAR score at 1 and 5 min and labor characteristics were recorded. Results: The groups were comparable in demographic and obstetric characteristics. Two patients in Group BF developed motor block of Grade 1 while none of the patient in Group RF had motor block. VAS score and quality of analgesia was comparable in both the groups. Onset of sensory block was longer in Group RF. No significant difference was found in both groups with regards to hemodynamics. Conclusion: We conclude that ropivacaine 0.1% with fentanyl produced excellent analgesia comparable to bupivacaine 0.1% with fentanyl and can be used safely for labor epidural analgesia.

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