comparison of equipotent low concentrations of epidural bupivacaine or ropivacaine with sufentanil for labor analgesia

ABSTRACT

In a double-blind study, we compared the effects of epidural bupivacaine 0.06% and ropivacaine 0.1% with sufentanil for analgesia during labor. One hundred parturients were randomly assigned to receive epidural analgesia using intermittent bolus doses of 10 ml of either 0.06% bupivacaine with 10 micro g sufentanil [n = 50] or 0.1% ropivacaine with 10 micro g sufentanil [n = 50]. Pain score, modified Bromage score for motor block, onset, duration and quality of analgesia, total analgesic doses, duration of first and second stages of labor, mode of delivery, umbilical cord pH, Apgar scores of the newborn were recorded. Also, oxygen saturation, blood pressure, heart rate and any side effects were recorded. Pain relief started after 10 min, and continued for approximately 100 min in both groups. The percentage of women who had adequate analgesia during first and second stages of labor were 98, 92% in bupivacaine group and 94, 88% in ropivacaine group, respectively [p > 0.05]. Full range of motion was present in 86% of women in bupivacaine group and 90% in ropivacaine group [p > 0.05]. The incidence of instrumental deliveries was only 20% in bupivacaine group and 16% in ropivacaine group [p> 0.05]. Side effects were not troublesome and there was no detrimental effect on the mothers or their babies. Epidural administration of equipotent concentrations of bupivacaine 0.06% or ropivacaine 0.1% combined with 10 micro g sufentanil produces an adequate analgesia for labor without jeopardizing the safety of the mothers or the r babies. Analgesia produced by this mixtures, is associated with minimal motor blockade, normal duration of labor, low incidence of instrumental deliveries and minor side effects