A COMPARATIVE STUDY OF 0.125% ROPIVACAINE WITH FENTANYL 2 MCG/ML VERSUS 0.125% BUPIVACAINE WITH FENTANYL 2MCG/ML FOR LABOUR EPIDURAL ANALGESIA
Journal Title: Journal of Evidence Based Medicine and Healthcare - Year 2018, Vol 5, Issue 22
Abstract
BACKGROUND This study was undertaken to determine whether epidural analgesia is superior to all methods of pain relief for labour. Previous studies compared different concentrations of local anaesthetics epidurally with or without additives. Here ropivacaine is compared because, it is a new long acting amide local anaesthetic agent which is less lipophilic than bupivacaine and is less likely to penetrate large myelinated motor fibres, resulting in relatively reduced motor blockade. The reduced lipophilicity is associated with decreased potential of central nervous system toxicity and cardiotoxicity. Because of its favourable pharmacokinetic profile, the ropivacaine is chosen for labour epidural in comparison with bupivacaine. Aims and Objectives- to compare smaller concentration of epidural ropivacaine with bupivacaine in intermittent doses for obstetric analgesia by adding fentanyl to ropivacaine and bupivacaine solutions. MATERIALS AND METHODS In this prospective randomised double-blind study, sixty women in labour were randomly allocated to receive either bupivacaine 0.125% with fentanyl 2 mcg/ml or ropivacaine 0.125% with fentanyl 2mcg/ml. visual analogue scale was used to test sensory block and pain respectively. Bromage scale was used to test motor block. Haemodynamic parameters, duration of labour, APGAR score for 1 and 5 minutes, dose requirement of drug to produce analgesia, incidence of side effects were also recorded. Data was expressed as mean ± standard deviation and analysed using students unpaired t test, chi square test at p-value <0.05. RESULTS Regarding haemodynamic stability, onset of analgesia, quality of analgesia, sensory blockade, neonatal outcome, requirement of drugs, duration of labour and incidence of side effects both drugs showing similar results. Five parturients in bupivacaine group had a motor block of Bromage score 2 and were delivered with assistance. None of the parturients in ropivacaine group had any motor block and all had spontaneous vaginal delivery, but this difference was not statistically significant. CONCLUSION Ropivacaine 0.125% with fentanyl 2mcg/ml produces similar analgesia with significantly less motor block than a similar concentration of bupivacaine with fentanyl during labour.
Authors and Affiliations
Vallem Balasubramanyam, Talisetti Jamuna, Vakkakula Kiran Reddy
Keywords
Related Articles
- EP ID EP561281
- DOI 10.18410/jebmh/2018/356
- Views 97
- Downloads 0
AN OPHTHALMOLOGICAL STUDY OF ECTOPIA LENTIS, WITH MULTIFARIOUS AETIOPATHOGENESIS, DIVERSE CLINICAL PRESENTATIONS AND VARIED PROGNOSES
BACKGROUND Ectopia lentis is a hereditary or acquired displacement or malposition of the lens, from its normal position, with traumatic and non-traumatic aetiopathogenesis like homocystinuria due to cystathionine ß-synth...
MICROBIOLOGICAL STUDY OF CSOM AT KIMS - AMALAPURAM
BACKGROUND In India, Chronic Suppurative Otitis Media (CSOM) is a major public-health problem with a high-prevalence rate. Several organisms have been implicated in the causation of CSOM, posing a challenge to the manage...
A RETROSPECTIVE STUDY OF CASE PROFILE, MATERNAL OUTCOME IN CASES OF ACUTE UTERINE INVERSION IN A TERTIARY CARE HOSPITAL
: Acute uterine inversion is a rare and life-threatening post-partum complication which often occurs when the placenta fails to detach from the uterus after childbirth. The uterine fundus falls into the endometrial cavit...
PAEDIATRIC OCULAR INJURIES IN A TERTIARY CARE HOSPITAL
BACKGROUND Childhood blindness constitutes a burden on the economy of the country and produces psychosocial and emotional disturbance to the child and family at large. Similar to the visual impairment produced by vitamin...
DIAGNOSTIC ACCURACY OF SQUASH CYTOLOGY IN CENTRAL NERVOUS SYSTEM TUMOURS
BACKGROUND Intraoperative squash smear cytology is an important diagnostic tool; it guides the neurosurgeon during surgical resection; it also helps the surgeon to monitor and modify the approach to surgery. Hence prompt...