Comparative Evaluation of 0.2% Ropivacaine versus 0.125% Ropivacaine under Combined Spinal-epidural Technique for Labor Analgesia
Journal Title: INTERNATIONAL JOURNAL OF SCIENTIFIC STUDY - Year 2019, Vol 6, Issue 11
Abstract
Background: Both pharmacological and non-pharmacological strategies for pain relief in labor have been tried and tested since long. Combined spinal-epidural analgesia (CSEA) satisfies the basic requisites of labor analgesia. Various concentrations of local anesthetics along with the addition of opioids can be used. The objective of this study is to compare the quality of labor analgesia with two different concentrations of ropivacaine (0.2% vs. 0.125%) and assess fetomaternal outcome. Materials and Methods: A total of 60 primipara women with a singleton pregnancy in active labor were given CSEA after randomly allocating them in two groups of 30 each. Both Group A and Group B received intrathecal injection of 4 mg (2 ml) 0.2% ropivacaine + 25 μg (0.5 ml) fentanyl: Group A - epidural dose of 15 ml of 0.2% ropivacaine solution + 2 μg/ml fentanyl and Group B - epidural dose of 15 ml of 0.125% ropivacaine + 2 μg/ml fentanyl. Then, continuous epidural infusion was started at the rate of 10 ml/h which was continued until the end of delivery. Results: Group A showed better maintenance of analgesia and better maternal satisfaction while parturients in Group B needed rescue top-up analgesia due to breakthrough pain. Conclusions: It was concluded that ropivacaine in both concentrations (0.2% and 0.125%) with fentanyl is effective for initiation of labor analgesia. However, quality of analgesia with 0.2% ropivacaine concentration is superior to 0.125% concentration.
Authors and Affiliations
Sujata Sharma, Veena Chatrath, Ranjana Khetarpal, Puneetpal Kaur
Keywords
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