Comparison of 0.1% Ropivacaine-Fentanyl with 0.1% Bupivacaine-Fentanyl Epidurally for Labour Analgesia

Abstract

Ropivacaine is an alternative to epidural bupivacaine, with greater selectivity for sensory fibres than motor fibres, thus producing less motor blockade as compared to bupivacaine. The purpose of this study was to evaluate the efficacy of Ropivacaine 0.1% when administered epidurally for the relief of labour pain and to compare it with 0.1% bupivacaine, conducted at Rajindra Hospital Patiala, Baba Farid University of Health and Sciences, on 20 parturients after ethical approval from the institutional review board and obtaining written informed consent. Participants were randomly allocated to the two groups (bupivacaine 0.1% (Sensorcaine) + fentanyl 20 g versus ropivacaine 0.1% (Ropin) + fentanyl 20 g). It was observed that ropivacaine 0.1% and bupivacaine 0.1%, with fentanyl 20 g/mL, produced equivalent analgesia for labour. There were no statistically significant differences in the amount of local anaesthetic used, pain scores, sensory levels, motor blockade, labour duration, mode of delivery, and side effects or patient satisfaction amongst the two local anaesthetics using the intermittent top-up technique. We conclude that the combinations of ropivacaine or bupivacaine with fentanyl achieve equally effective and excellent labour analgesia with no motor blockade and without jeopardizing the safety of the mother and foetus and, hence, are recommended for labour analgesia.

Comparison of bupivacaine and ropivacaine in combination with fentanyl used for walking epidural anesthesia in labor

“…Our findings regarding neonatal outcomes were comparable with the literature ( 4 , 13 , 14 , 15 , 16 ) . There were no significant differences in the indicators of neonatal wellbeing between the two groups.…”

“…Shokry et al ( 18 ) compared two groups receiving 0.125% bupivacaine and 0.2% ropivacaine, each with fentanyl 100 µg and found an non-significant faster onset of action and significantly shorter duration of analgesia in the ropivacaine group. In contrast, Chora and Hussain ( 4 ) showed significantly faster onset of analgesia in the bupivacaine group and longer duration in the ropivacaine group. Unlike these, the onset and duration of analgesia for both groups was comparable in current study, consistent with the research of Beilin et al ( 19 ) .…”

“…It is assumed that ropivacaine has a greater selectivity for sensory fibers than motor fibers due to its lower lipophilic capacity compared with bupivacaine. Accordingly, it is less likely to cause motor blockade and neurotoxicity ( 4 , 6 ) . There were no cases of motor blockade in either group in our study.…”

“…Walking epidural analgesia on labor reveals lower pain scores, leading to higher maternal satisfaction with better cardiovascular and pulmonary physiology ( 3 ) . The ideal drugs to be used for labor analgesia should have a long duration of action with minimum motor blockade, limited placental transfer, and no significant adverse effects on the mother and fetus ( 4 , 5 ) . Bupivacaine is the most commonly used drug for this purpose.…”

A Comparative Analysis of Ropivacaine- Fentanyl vs Bupivacaine-Fentanyl in Labour Analgesia

“…We found that there was non-significant difference in MAP, MHR and FHR in group I and II at baseline and lowest value (P> 0.05). Chora et al, [9] observed that ropivacaine 0.1% and bupivacaine 0.1%, with fentanyl 20 μg/mL, produced equivalent analgesia for labour. There were no statistically significant differences in the amount of local anaesthetic used, pain scores, sensory levels, motor blockade, labour duration, mode of delivery, and side effects or patient satisfaction amongst the two local anaesthetics using the intermittent top-up technique.…”