Effect of intrathecal labor analgesia using fentanyl 25μg alone and fentanyl 20μg plus bupivacaine 2.5mg on the progress of labor
Journal Title: Medpulse International Journal of Anesthesiology - Year 2019, Vol 10, Issue 2
Abstract
Background: The aim of this study was regarding the effect of intrathecal analgesia using fentanyl or fentanyl and bupivacaine combination during normal vaginal delivery on onset and duration of analgesia, pain scores in the mother, on the progress of labor and hemodynamic changes in the mother and fetus. Materials and Methods: Sixty primigravida in the active phase of labor with a cervical dilatation of> 3to <5 cm was selected for this prospective study. Group A (n = 30) received an intrathecal injection fentanyl 25 μg only compared with Group-B(n = 30) with 20 μg of fentanyl plus 0.5% hyperbaric bupivacaine 2.5 mg. Result: Onset of sensory blockade 3.88±0.1min in group-A and 3.64±0.06min in the group –B. Duration of sensory block 138.23±13.55 and131.83±12.45 in both the groups respectively, p-value, 0.05. Duration of the active phase of first stage of labor was slightly shortened in group A as compared to group-B (117.9vs118.37) min. Duration of the second stage of labor was slightly prolonged in group-B as compared to group A (22.2vs25.07min,) and significant p-value. Rate of cervical dilation was faster in group A as compared to group-B (1.9 3 vs. 1.94 cm/h). Statistically significant changes noticed in the mean visual analog score, pulse rate, and mean arterial pressure and the fetal heart rates from the base level to at 4th and 10 min in their respective in A and B groups. Conclusions: Single-shot intrathecal analgesia with fentanyl. 25 μg or fentanyl 20 μg +bupivacaine 2.5 mg useful when given in the active phase of first stage of labor had a rapid onset with a satisfactory pain relief in both the groups and minimal motor block in group-B, with VAS scores <4 and good maternal and fetal hemodynamic.
Authors and Affiliations
Gowrisree Kadimi, Gopal Reddy Narra, Gopinath Sayani, Pratusha . , Showri Reddy
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