A Comparative Study of Efficacy of Bupivacaine and Ropivacaine with Fentanyl in Epidural Labour Analgesia
Journal Title: Indian Journal of Anesthesia and Analgesia - Year 2019, Vol 6, Issue 4
Abstract
Introduction: Labour is a highly complex and personal process for every woman. Analgesic intervention is a matter of personal choice for delivery. Local anesthesia given as an epidural injection along with an opioid gives quicker analgesia without impeding motor activity. Bupivacaine and Ropivacaine are commonly employed drugs to provide efficient epidural analgesia in labour. Aims: To compare the efficacy of ropivacaine with fentanyl and bupivacaine with fentanyl given as continuous infusion in labour epidural analgesia. Materials and Methods: This was a prospective randomized control trial wherein 70 women in labour were studied. These 70 parturients were randomly put into two groups. Group A (n=35) received 12 ml of 0.125% ropivacaine as the initial bolus followed by 8 ml/hour infusion of 0.125% ropivacaine with 2 µg/ml fentanyl. Group B (n=35) received 12 ml of 0.125% bupivacaine as initial bolus followed by 8ml/hour infusion of 0.125% bupivacaine with 2 µg/ml fentanyl. Various parameters like duration of labour, mode of delivery, neonatal outcome and complications were noted and compared for both the groups. Results: Both the groups showed minimal fluctuations in pain that were clinically and statistically insignificant. The spontaneous deliveries were similar in both groups. The rate of instrument assisted delivery and caesarean delivery was similar in both groups. No adverse neonatal outcome (because of the drugs used) in the form of low APGAR scores or admission to NICU were noticed in both the groups. Motor block was not statistically significant. The incidence of complications was minimal and comparable in both groups. Conclusion: Ropivacaine used at lower concentration (0.125%) offers good pain relief equivalent to that of bupivacaine. Both the drugs give similar results as regards the duration of labour, mode of delivery, neonatal outcome and complications. Though ropivacaine is less potent than bupivacaine, its safety and efficacy is equivalent to bupivacaine.
Authors and Affiliations
Amudala Sivaram
A Comparative Study of Dexmedetomidine and Clonidine as Adjuvant to Propofol for Insertion of Laryngeal Mask Airway
Objective:To evaluate theease of insertion ofLaryngeal Mask Airway (LMA) and hemodynamic response during insertion of LMA with two adjuvants, dexmedetomidine & clonidine along with induction agent propofol. Methods: Hund...
A Prospective Randomised Control Study to Compare Hyperglycemic Stress Response to General Anaesthesia in Non Diabetics and Controlled Diabetics Posted for Elective Surgical Procedures
Diabetic patients presenting for elective surgical procedures will place an increasing burden on anaesthetic services. The effects of surgical stress and anesthesia result in a a hypermetabolic stress response, referred...
Is General Anaesthesia with Paediatric Epidural Anaesthesia Superior to General Anaesthesia Alone in Improving Postoperative Outcome?: A Clinical Study
Background: Paediatric epidural anaesthesia and analgesia (PEA) is being accepted as a standard method of advanced pain management as epidural catheter offers the advantage of excellent long term post-operative analgesia...
Effect of Dexmedetomidine Infusion on Halothane Requirement to Provide Oligaemic Surgical Field during Middle Ear Surgery under General Anaesthesia
Introduction: Middle ear surgeries require hypotensive anaesthesia to improve quality of surgical field. Dexmedetomidine is α2 agonist which provides desired surgical field, sedation and analgesia. Aim: The present study...
Comparison of Spinal and General Anaesthesia in Patients Undergoing Caesarean Section: A Prospective Study at a Tertiary Care Teaching Hospital
Background: Cesarean section (CS) is one of the most common surgical procedures today. About 20-25% of all birth is by CS. Surgery and anesthetic technique employed has been shown to effect postoperative outcomes, specif...