Epidural labor analgesia, a comparative study, ropivacaine 0.2% verses bupivacaine 0.125%
Journal Title: MedPulse -International Medical Journal - Year 2015, Vol 2, Issue 1
Abstract
Background: Epidural labor analgesia is an attractive pain reliving technique in the labor. The parturients remain pain free, comfortable and mobile and can co-operate in labour in very good manner and enjoy the birth of their baby instead of suffering from agonizing pain of labor. We conducted a study at Jilla Hospital Aurangabad on the two different drugs i.e. Inj. Bupivacaine in concentration of 0.125% and Inj. Ropivacine in concentration of 0.2% with added Inj. Fentanyl 20 μg. Objectives: The purpose of present study is to compare analgesic potency and the level of motor blocked of the Ropivcaine 0.2% with Bupivacaine 0.125% in labor analgesia. Material and Methods: 70 parturients were included in study 35 each group. Epidural catheter (Portex) was placed in L3-4 to L5- S1 space with loss of resistance (LOR) to 0.9% saline was used to detect the space. Test dosing with Inj Lidocaine with Adrenaline 3 ml was given and a bolos dose of the study solution in volume of 8 to 10 ml with Inj fentanyl 20 μg given. The analgesia was noted on VAS (Visual Analogue Scale) as less than 3 as good pain relief and motor blocked measure on modified Bromage scale as 0 to 3. Results: In our study we found that the labor analgesia and motor blocked in both the groups were comparable, not clinically significant difference but the pain relief was better in single dose in Ropivacaine group than Bupivacaine group. Parturients were more comfortable with Ropivacaine group. the onset time after the dose was less in more number of parturients in Ropivacine group, where many patients need another dose of Inj Bupivcaine to achieve the required level of analgesia i.e. VAS < 3 Again it`s a observation of the obstetrician who conducted the deliveries that the time to delivery of baby was reduced in all the parturients who received the labor analgesia. The mode of delivery was not altered due labor analgesia. Conclusion: Overall we, the team, will say that though the data may not be significant in both the groups but we definitely are in more favor of Inj. Ropivacine for labor analgesia because of onset in significant number of parturients is far short, motor blocked is not a problem at all, less cardio toxicity and neuro toxicity, the concentration we had used for Ropovcaine i. e. 0.2% is commercially available so no problem in giving the exact concentration.
Authors and Affiliations
Arvindanand Rajgure, Ajit Ghayal
Keywords
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