ABSTRACT
Background: Both pharmacological and non-pharmacological strategies for pain relief in labor have been tried and tested sincelong. Combined spinal-epidural analgesia (CSEA) satisfies the basic requisites of labor analgesia. Various concentrations oflocal anesthetics along with the addition of opioids can be used. The objective of this study is to compare the quality of laboranalgesia with two different concentrations of ropivacaine (0.2% vs. 0.125%) and assess fetomaternal outcome.Materials and Methods: A total of 60 primipara women with a singleton pregnancy in active labor were given CSEA afterrandomly allocating them in two groups of 30 each. Both Group A and Group B received intrathecal injection of 4 mg (2 ml)0.2% ropivacaine + 25 µg (0.5 ml) fentanyl: Group A - epidural dose of 15 ml of 0.2% ropivacaine solution + 2 µg/ml fentanyland Group B - epidural dose of 15 ml of 0.125% ropivacaine + 2 µg/ml fentanyl. Then, continuous epidural infusion was startedat the rate of 10 ml/h which was continued until the end of delivery.Results: GroupA showed better maintenance of analgesia and better maternal satisfaction while parturients in Group B neededrescue top-up analgesia due to breakthrough pain.Conclusions: It was concluded that ropivacaine in both concentrations (0.2% and 0.125%) with fentanyl is effective forinitiation of labor analgesia. However, quality of analgesia with 0.2% ropivacaine concentration is superior to 0.125%concentration.