Epidural Labour Analgesia With Low Dose of Bupivacaine With Low Dose of Fentanyl vs Butorphanol

Abstract

BACKGROUNDEpidural analgesia is the most commonly accepted and used technique for painless labour. Local anaesthetic bupivacaine when combined with low dose of opioid analgesics gives excellent results.The aim of this study is to evaluate and compare the efficacy and safety of epidural fentanyl vs butorphanol for painless labour and effect on newborn (Apgar score).Settings and Design -Randomised double-blind trial. MATERIALS AND METHODS50 parturients were randomly allocated in two groups. Group I: receive epidurally 15 mL bupivacaine 0.0625% + fentanyl 30 mcg and Group II: receive epidurally 15 mL bupivacaine 0.0625% + butorphanol 1 mg. RESULTSThe mean onset of analgesia was faster in Group I, whereas duration of analgesia was longer in Group II. There was no incidence of motor block, high rate of Normal Vaginal Delivery and very low incidence of forceps application or LSCS in both the groups. Somnolence was the main side effect in Group II and other side effects were seen equally in both groups. CONCLUSIONThe addition of low dose of opioids has greatly improved the quality of labour analgesia and at the same time reduced the incidence of instrumental deliveries and LSCS without depressing the neurobehavioral status of the newborn.