International Journal of Medical and Health Research

International Journal of Medical and Health Research


International Journal of Medical and Health Research
International Journal of Medical and Health Research
Vol. 2, Issue 1 (2016)

0.5% ropivacaine with fentanyl in combined spinal epidural for labor analgesia: Comparison with 0.25% ropivacaine with fentanyl and 0.25% bupivacaine with fentanyl


Dr. S. Sivakumar, Dr. K. Harikaran, Dr. L. Sanjiv

Background: The pains of labor result in a maternal stress response, which is neither beneficial for the fetus nor the mother [1]. Hence, maternal pain relief not only benefits the parturient, but her neonate also [2]. Studies have also shown that the newer, low-dose regimes do not have a statistically significant impact on the duration of labor and breast feeding and also that these reduce the instrumental delivery rates thus improving maternal and foetal safety [3]. Central neuraxial analgesia is the most versatile method of labour analgesia and the gold standard technique for pain control in obstetrics that is currently available [5]. The availability of newer local anaesthetics like ropivacaine and levo-bupivacaine have contributed towards the increased maternal safety in terms of being less cardiotoxic after an inadvertent IV injection.
Materials and method: This Prospective, randomised comparative study was conducted in 60 ASA physical status I or II women with term pregnancy, single, vertex presentation in active labour (cervical dilatation 3-4 cm) requesting labour analgesia.
Result: VAS pain scores were significantly lower in group 3 than in group I and II at 5 min, 60 min and 90 min of the study period, P < 0.001. Parturient and anesthesiologists graded acceptance rate as either excellent or “good” in all groups. Neonatal outcome was favorable in both the groups (APGAR scores >7 at 1 and 5 min) with no side-effect.
Conclusion: The results from our study support that intra-thecal 5mg ropivacaine with fentanyl and ropivacaine epidural top-up is a suitable choice for labour analgesia. The addition of opiods is always necessary to achieve good analgesia, high maternal satisfaction and acceptable motor blockade.
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