A Comparative Study on the Effects of 0.1% Bupivacaine and 0.15% Ropivacaine for Epidural Analgesia During Labour
Journal Title: International Journal of Contemporary Medical Research - Year 2018, Vol 5, Issue 12
Abstract
Introduction: Epidural analgesia is the most versatile method of labour analgesia commonly administered. Bupivacaine is the most commonly used drug because of its long duration of action, limited placental transfer. However it is associated with cardiotoxicity and motor blockade at higher concentrations which led to the discovery of Ropivacaine. Additives, like Fentanyl, improve the analgesic potency and reduce the dose of local anesthetics. According to minimum local analgesic concentration (MLAC), Ropivacaine was 40% less potent than Bupivacaine. Hence, this study was conducted to compare equianalgesic concentrations of 0.1% Bupivacaine and 0.15% Ropivacaine for labour analgesia. Material and Methods: This study was carried out on 80 ASA grade I and II nulliparous patients, between 37 to 42 weeks of gestation with cervical dilatation between 3-6 cm, singleton pregnancy with cephalic presentation requesting epidural labour analgesia. They were randomly divided in the Bupivacaine Group and Ropivacaine Group. Intraoperative and postoperative analgesic parameters were observed. Results: The onset of analgesia was faster in the Ropivacaine Group than the Bupivacaine Group. Rest all the parameters were comparable. One case of Grade I motor blockade was observed in the Bupivacaine Group but the difference was statistically insignificant. The percentage of instrumental delivery was more in Ropivacaine Group. Conclusion: Both drugs are safe and provide equivalent analgesia in equianalgesic concentration. But Ropivacaine provides faster onset of epidural analgesia during labour and also leads to increased incidence of instrumental deliveries.
Authors and Affiliations
Snehal Shrikant Shenvi, Ashutosh Vijay Jaiswal
Keywords
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