Epidural labor analgesia: A comparison of ropivacaine 0.125% versus 0.2% with fentanyl

Chhetty, Yogesh Kumar; Naithani, Udita; Gupta, Sunanda; Bedi, Vikram; Agrawal, Ila; Swain, Lalatendu

doi:10.4103/2249-4472.114284

Cited by 6 publications

(1 citation statement)

References 0 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…A combination of local anaesthetics with lower doses of opioids resulted in lower rates of instrumental deliveries [21,22]. Chetty et al in their study evaluated 0.125% vs 0.2% ropivacaine for epidural labor analgesia regarding sensory and motor block characteristics and found comparable maternal expulsive efforts, instrumental delivery and fetal outcome in both the groups [23]. Chethananand et al evaluated efficacy of 0.0625% racemic bupivacaine and 0.1% of ropivacaine with 2 μg/ml of fentanyl and observed no significant difference in maternal satisfaction, mode of delivery, incidence of instrumentation and fetal outcome in two groups [24].…”

Section: Discussionmentioning

confidence: 99%

Comparison of Ropivacaine-Fentanyl with Bupivacaine-Fentanyl for Labour Epidural Analgesia

Kulkarni¹,

Patil²

2020

TOATJ

View full text Add to dashboard Cite

Background: Bupivacaine with opioid is commonly used for labour epidural analgesia. Ropivacaine is considered as an alternative to bupivacaine due to its lower cardiovascular complications. However, there is a controversy regarding the efficacy of these drugs as some studies suggest equivalent action, whereas others report that ropivacaine produces less motor blockade. The study aimed to compare the effect of ropivacaine-fentanyl and bupivacaine-fentanyl for labour analgesia. Materials and Methods: The prospective randomized study was performed on 60 parturients, divided into two groups of 30 subjects each. Group I received 10ml of bupivacaine 0.1% + fentanyl 2µg/ml and Group II received 10ml of ropivacaine 0.1% + fentanyl 2µg/ml by epidural catheter. Pre-anaesthetic evaluation was performed on all the participants and all were administered metoclopramide 0.25mg/kg and ondansetron 0.08-0.1mg/kg intravenously as premedication. The baseline and post anaesthesia systolic, diastolic blood pressure, heart rate, VAS score, degree of motor block, sedation and APGAR score of the baby were recorded. The data were tabulated and statistically analyzed. Results: When compared, there was no significant difference in systolic/diastolic blood pressure in two groups except at 360 min where diastolic pressure was low in group II. Significantly higher heart rate at 30 min (P=0.0003), 120 min (0.006), and 300 min (P=0.001) was observed in group I subjects. VAS score was significantly less at 180 min (P=0.019) and 300 min (P=0.019) in group II. Adverse effects such as fetal bradycardia, nausea/vomiting and hypotension observed were clinically insignificance when compared in two groups. Conclusion: Bupivacaine and ropivacaine produce an equal degree of analgesia and hemodynamic stability in 0.1% of concentration when added with 2µg/ml fentanyl . However, heart rate was well maintained with lower VAS scores in group II receiving ropivacaine. No significant difference in the side effects between the two groups. Hence, Ropivacaine can be used as a safe alternative to bupivacaine for labour epidural analgesia.

show abstract

Section: Discussionmentioning

confidence: 99%