A COMPARISON OF ROPIVACAINE 0.125% VERSUS ROPIVACAINE 0.0625% WITH FENTANYL.

Dr. Neelam Singh, Dr. Birendra Kumar Raw, Dr. Poonam, Dr. Amrita Chaurasia

Abstract


Background : To minimize the concentration of local anaesthetics by comparing the sensory and motor effects by two different concentrations with or without adjuvants.

Aim:. To compare the efficacy of epidural analgesia using 0.125% Ropivacaine versus an 0.0625% Ropivacaine with 2µg/ml Fentanyl for labour analgesia.

Methods: A total of 60 parturients in active labour were randomly assigned into two groups (R and R+F) of 30 patients each, to receive an epidural injection of 15 ml of Ropivacaine 0.125% in R group and 15 ml Ropivacaine 0.0625% with Fentanyl (2 µg/ml) in group R+F as initial bolus dose. Same dose regimen were used as subsequent top-up dose on patients demand for pain relief. The duration and quality of analgesia, motor block, top-up doses required consumption of Ropivacaine and Fentanyl and feto-maternal outcome in both groups

Result:  Epidural top-up technique using 0.125% Ropivacaine (group R) analgesia was similar to that using 0.0625% Ropivacaine (group R+F) with 50µg Fentanyl, but motor power was retained allowing women to mobilize. There also appear to be beneficial effects on the progress of labour, with a clinically important reduction in the length of the second stage.

.Conclusion: Our study resulted that establishing epidural analgesia in labour with 15ml of 0.125% Ropivacaine ( in group R) followed by top- ups of 10ml of 0.125% Ropivacaine, produced similar analgesia to that obtained from the same volume of 0.0625% Ropivacaine with 2µg Fentanyl (in group R+F), but motor block was minimized (termed as Walking Epidural ). No significant neonatal depression was seen in our study.

So it would be better to give 0.0625% Ropivacaine with 2µg Fentanyl for better management of pain in obstetric patients without any effect on fetal respirationand better management of labour pain.


Keywords


Epidural Labour Analgesia, Ropivacaine, Fentanyl, VAS scale , Bromage score

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