---

A prospective randomised double blind clinical study comparing ropivacaine and fentanyl with bupivacaine and fentanyl for labour epidural analgesia

Full Text PDF

---

Null

Author Details : Apoorva Gupta, Manasa Dhananjaya*, Nagaraja PS, Naveen G Singh, Nanjappa SN

Volume : 6, Issue : 1, Year : 2019

Article Page : 81-88

https://doi.org/10.18231/2394-4994.2019.0016

Suggest article by email

Get Permission

Abstract

Introduction: The ideal labour analgesia technique should dramatically reduce the pain of labour, while allowing the parturient to actively participate in the birthing experience. In addition, it should have minimal effect on the fetus and the progress of labour. A randomised prospective comparative clinical study using epidural Inj ropivacaine hydrochloride (0.125%) with Inj fentanyl citrate 2µg/ml was compared with Inj Bupivacaine hydrochloride (0.125%) with Inj fentanyl citrate 2µg/ml for onset and quality of analgesia, incidence of motor block, progress, duration and outcome of labour, incidence of instrumental deliveries and neonatal outcome.
Materials and Methods: A total of 65 Full term labouring parturients of ASA I and II grade with cephalic singleton pregnancy from 36 to 42 weeks of gestation having cervical dilatation of 4-5 cm were enrolled in this study. Group R (Ropivacaine): received epidural Inj ropivacaine hydrochloride (0.125%) with inj fentanyl citrate 2µg/ml as a continuous infusion at 6 ml/h after a bolus dose of 15ml of the above drug combination. Group B (Bupivacaine): received epidural Inj bupivacaine hydrochloride (0.125%) with inj fentanyl citrate 2 µg/ml as a continuous infusion at 6 ml/h after a bolus dose of 15ml of the above drug combination. Hemodynamic parameters, onset of analgesia, modified bromage scale for motor blockade, pain scores were documented and compared between the two groups.
Results: The mean time for onset of analgesia after the bolus dose via the epidural catheter was also similar in both the groups. It was 16.03 m in ropivacaine group and 15.33 m in bupivacaine group. Verbal pain score and Visual analogue scale were also comparable between the two groups. Motor block was mild (0 to 1) in most of the parturients and did not differ with ropivacaine or bupivacaine treatment. Neonatal outcome was similar in both the groups in our study. All the infants had Apgar score more than 7 at 5 minutes after delivery.
Conclusion: We found the combination of ropivacaine (0.125%) with fentanyl (2 ?g/ml) when compared to bupivacaine (0.125%) with fentanyl (2 ?g/ml) as a good alternative drug for labour analgesia with minimal side effects.

Keywords: Bupivacaine, Ropivacaine, Fentanyl, Labour analgesia, Epidural.

How to cite : Gupta A, Dhananjaya M, Nagaraja Ps, Singh N G, Nanjappa Sn, A prospective randomised double blind clinical study comparing ropivacaine and fentanyl with bupivacaine and fentanyl for labour epidural analgesia. Indian J Clin Anaesth 2019;6(1):81-88

This is an Open Access (OA) journal, and articles are distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as appropriate credit is given and the new creations are licensed under the identical terms.