COMPARISION OF TWO DRUG COMBINATIONS FOR LABOUR ANALGESIA, AND ITS EFFECT ON PATIENT SATISFACTION, DURATION OF LABOUR AND FETAL OUTCOME

BACKGROUND: Epidural is now established and accepted method to relief labour pain. This study intended to comparison of two drug combinations in labour analgesia and its effect on duration of labour, maternal satisfaction and fetal outcome. Combined epidural infusion of bupivacaine + fentanyl would result in analgesia superior to that provided by a continuous epidural infusion of a similar concentration of Bupivacaine alone. AIMS AND OBJECTIVE: To compare the efficacy of two drug combinations for labour analgesia, and its effect on patient satisfaction, duration of labour and fetal outcome. MATERIALS AND METHODS: Study design - comparative randomized controlled study. Sample size: For this study 50 pregnant women were randomly selected and divided into two groups. GROUP I: Control Group (Continuous epidural infusion of Bupivacaine CEI): 25 parturient who were given a bolus of 0.1% Bupivacaine + 20mcg Fentanyl followed by infusion of 0.0625% Bupivacaine epidurally. GROUP II: Study Group (Continuous epidural infusion of Bupivacaine with Fentanyl CEIF): 25 parturients who were given a bolus of 0.1% Bupivacaine + 20mcg Fentanyl followed by infusion of 0.0625% Bupivacaine + 0.0001% Fentanyl epidurally. Duration of labour, Analgesia, maternal satisfaction, fetal outcome was assessed by different scales like bromage scale, visual analogue scale, APGAR score and pin prick method are used. Side effects and complications, if present were recorded. Tests used for statistical analysis were STUDENT'S tTEST, CHI SQUARE TEST AND FISHERS EXACT TEST RESULTS: 1) The drugs in the concentrations used for this study were safe for both the mother and the foetus as there were no significant alterations seen in the vital parameters of the mother (pulse and blood pressure) or the foetal heart rate and neonatal Apgar scores. 2) Parturients in study group (Fentanyl infusion) had consistently lower VAS scores (a difference not statistically significant, however) and needed less number of rescue doses as compared to control group (which was also not statistically significant). 3) Incidence of Caesarean section was equal in both the groups and incidence of instrumental deliveries was also comparable to previous studies, proving the safety of this infusion regimen. 4) The mean duration for the second stage was 36.40 +/- 13.60 for the control group and 48.20 +/- 10.75 for the study group. This difference was statistically significant since p value was 0.001. Thus we conclude that 0.0625% Bupivacaine + 0.0001% Fentanyl provides better labour analgesia and maternal satisfaction with good fetal outcome.