A Comparison of Low – Concentration Ropivacaine (0.075%) with Fentanyl Versus Bupivacaine (0.05%) with Fentanyl for Labour Epidural Analgesia

ABSTRACT

Introduction: Providing effective as well as safe analgesiato the parturients in labour is always a concerned for theanaesthesiologists. We conducted this study to compare theanalgesic efficacy and fetomaternal outcome of ropivacaineand bupivacaine at equianalgesic dose with fentanyl in lowdose infusion.Material and Methods: This prospective, single blind studywas carried on 60 nulliparous parturients of ASA grade Iand II, with uncomplicated singleton, term pregnancy. Thepatients were randomly divided into two groups, to receivebolus dose of either 20 ml of 0.075% Ropivacaine and 0.05%Bupivacaine with fentanyl 2 µg/ml in Group RF and GroupBF respectively, followed by infusion at the rate of 10ml/hr.Onset of analgesia, motor block, maternal hemodynamics,mode of delivery and foetal outcome was assessed.Results: Visual Analog Scale (VAS) score < 3 was achievedin 25 min in Group RF as compared to 30 min in Group BF. At30 min, 77% parturients achieved T10 as compared to 50% ingroup BF. Maternal haemodynamics, APGAR score, umbilicalcord blood analysis was comparable in both the groups. Noneof the patients had motor block in both groups. The percentageof instrumental delivery was more in Group RF.Conclusions: The onset of analgesia was faster in Group RFas compared to Group BF. However once the analgesia wasestablished, both the groups had effective and satisfactoryanalgesia throughout the labour with good foetal outcome.The incidence of instrumental delivery was more in Group RF.