ABSTRACT
Background: Combined spinal epidural [CSE] analgesia, is wildly used to provide pain relief in labour. It provides rapid reliable analgesia with minimal motor blockade. In randomized, double blind study, we compared ropivacaine versus bupivacaine both with fentanyl during labour using CSE technique
Methods: Forty patients were allocated randomly to receive either 2.5 mg ropivacaine in group I or 2.5 mg bupivacaine in group 2 intrathecally, both with fentanyl 25 microg. Epidural top-up were given from premixed solution of 0.125% ropivacaine with 2 jig/mi fentanyi in group I or 0.125% bupivacaine with 2 microg/ ml fentanyl in group 2. Onset, duration of analgesia, level of sensory block, motor power in lower limbs, VAS scores, side effects as well as neonatal Apgar scores were evaluated
Results: There were no significant differences between the two groups regarding the onset, duration, level of sensory block an VAS scones during the study.25% of women [5/20] in bupivacaine group developed detectable motor blockade compared to 5% [1/20] in ropivacaine group. Adverse effects did not differ between the two groups, neontal outcome was similar in both groups
Conclusion: Using combined spinal epidural technique, ropivacaine with fentanyl provides rapid, safe, reliable analgesia for labour as effective as that achieved by bupivacaine with fentanyl. Motor blockade with significantly low with ropivacaine compared to bupivacaine