Patient-controlled Analgesia with Epidural Bupivacaine-Fentanyl Combination for Labor Analgesia

Background: Pain relief to the parturient in labor is one of the prime responsibilities of the anesthesiologist. Today with the availability of continuous epidural analgesia, we are able to achieve this goal with the patient satisfaction. Aim: To evaluate the efficacy of bupivacaine-fentanyl combination in alleviating labor pain, study its effects on mother and fetus and progress of labor and delivery. Materials and Methods: A total of 100 cases were selected at random and grouped 50 cases and 50 controls each. Satisfactory block was established with continuous epidural analgesia using initial loading dose of 10 ml of 0.25% bupivacaine with 50 mu g of fentanyl followed by background infusion of 0.125% bupivacaine with 0.5 mu g/ml of fentanyl, 10 ml/h. A patient-controlled analgesia dose of 5 ml with the lockout interval of 15 min was set. The patient's pulse, blood pressure, fetal heart rate, level of sensory analgesia, intensity of motor blockade, and sedation score noted. The nature of uterine contractions, duration of the first, second, and third stage, any complications during labor, nature of delivery, APGAR score were noted in both case and control groups. Results: Labor analgesia was excellent in 70% of the cases and good in 22% of the patients. Conclusion: We conclude that the patient-controlled continuous lumbar epidural analgesia with low dose bupivacaine-fentanyl combination provides effective pain relief during labor.